Active NPI
Bellin Memorial Hospital Inc
Doing business as FMC Brillion
- Family Medicine Physician
- Brillion, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- BELLIN MEMORIAL HOSPITAL INC
- Doing business as
- FMC Brillion
- Practice address
- 235 E Ryan St
Brillion, WI 54110-1132 - Phone
- (920) 756-2055
- Fax
- (920) 756-3350
- NPI assigned
- Apr 5, 2006
- Last updated
- May 28, 2025
- Organization subpart
- Yes
- Parent organization
- BELLIN MEMORIAL HOSPITAL INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abby Julia Engebose
- Title
- Credentialing Specialist
- Phone
- (920) 433-7860
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
235 E Ryan St
Brillion, WI 54110-1132
Mailing address
235 E Ryan St
Brillion, WI 54110-1132
Phone (920) 756-2055
Other names 1
- FMC BRILLION
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000089 | WI | Part B Supplier - Clinic/Group Practice | 8820900749 |
Receives reassigned benefits from 936 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Bellin Memorial Hospita
Locations (25 of 31)
106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155
1711 S Stephenson Ave
Ste 115
Iron Mountain, MI 49801
Phone (906) 774-6186
1721 S Stephenson Ave
Ste 215
Iron Mountain, MI 49801
212 E B St
Ste 212
Iron Mountain, MI 49801
901 Pyle Dr
Kingsford, MI 49802
Phone (906) 774-3779
100 Grant St
De Pere, WI 54115
Phone (708) 710-7696
1241 Lombardi Access Rd
Green Bay, WI 54304
Phone (920) 431-7120
1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687
301 Bay Park Sq
Green Bay, WI 54304
Phone (920) 499-3511
3263 Eaton Rd
Ste 1
Green Bay, WI 54311
Phone (920) 433-6000
704 S Webster Ave
#100A
Green Bay, WI 54301
704 S Webster Ave
Fl 2
Green Bay, WI 54301
704 S Webster Ave
Ste 100B
Green Bay, WI 54301
Phone (920) 433-3496
704 S Webster Ave
Ste 200
Green Bay, WI 54301
Phone (920) 433-3456
704 S Webster Ave
Ste 300
Green Bay, WI 54301
Phone (920) 468-3443
720 S Van Buren St
Ste 104
Green Bay, WI 54301
Phone (920) 433-7471
725 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-7995
725 S Webster Ave
Ste 303
Green Bay, WI 54301
Phone (920) 431-5650
744 S Webster Ave
#2
Green Bay, WI 54301
744 S Webster Ave
Fl 7
Green Bay, WI 54301
774 S Webster Ave
Green Bay, WI 54301
1304 1st St
Kewaunee, WI 54216
15481 Commercial Rd
Ste E
Lakewood, WI 54138
Phone (715) 276-9048
3415 Custer St
Manitowoc, WI 54220
Phone (920) 652-2440
3130 Shore Dr
Ste 104
Marinette, WI 54143
Phone 71573542004500
Practitioners & affiliated clinicians
Practitioners 460
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Green Bay, WI
- NPI 1487316006
-
- Physical Therapist
- Green Bay, WI
- NPI 1356869416
-
- Physical Therapist
- Green Bay, WI
- NPI 1770011256
-
- Family Nurse Practitioner
- Seymour, WI
- NPI 1265711311
-
- Anesthesiologist Assistant
- Milwaukee, WI
- NPI 1639715428
-
- Allergy & Immunology (Internal Medicine) Physician
- Green Bay, WI
- NPI 1689998262
-
- Addiction (Substance Use Disorder) Counselor
- Green Bay, WI
- NPI 1598063257
-
- Occupational Therapist
- Marinette, WI
- NPI 1346981453
-
- Anesthesiologist Assistant
- Green Bay, WI
- NPI 1033861729
-
- Podiatrist
- Green Bay, WI
- NPI 1346532678
-
- Family Nurse Practitioner
- Green Bay, WI
- NPI 1386288132
-
- Nurse Practitioner
- Two Rivers, WI
- NPI 1891198735
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748390400000",
"number": "1962464784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 E RYAN ST",
"city": "BRILLION",
"state": "WI",
"postal_code": "541101132",
"telephone_number": "920-756-2055",
"fax_number": "920-756-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 E RYAN ST",
"city": "BRILLION",
"state": "WI",
"postal_code": "541101132",
"telephone_number": "920-756-2055",
"fax_number": "920-756-3350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BELLIN MEMORIAL HOSPITAL INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BELLIN MEMORIAL HOSPITAL INC",
"enumeration_date": "2006-04-05",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A",
"authorized_official_last_name": "ENGEBOSE",
"authorized_official_first_name": "ABBY",
"authorized_official_middle_name": "JULIA",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "920-433-7860"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FMC BRILLION",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "FMC BRILLION",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Brillion, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.