CMS-1500 Box 24J / 33a • NPI
1033172390
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207Q00000X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
744 S WEBSTER AVE, GREEN BAY, WI, 54301-3505
✓ 9-Digit EDI 837 ZIP+4 (54301-3505)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1033172390 (BELLIN MEMORIAL HOSPITAL INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1033172390 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BELLIN MEMORIAL HOSPITAL INC |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207Q00000X (Family Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 744 S WEBSTER AVE, GREEN BAY, WI, 54301-3505 |
| Practice Telephone / Fax | Tel: (920) 445-7272 | Fax: (920) 433-6090 |
| Administrative Mailing Address | PO BOX 22487, GREEN BAY, WI, 54305-2487 |
| Enumeration & Last Sync | Enumerated: 2006-04-08 | CMS Record Updated: 2025-07-28 |
| Authorized Official | ABBY ENGEBOSE (Credentialing Specialist) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)
What Does Taxonomy Code 207Q00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BELLIN MEMORIAL HOSPITAL INC)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YP2500X — Counselor, ProfessionalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: N/A | License: Verified | Primary: Secondary |
207RC0001X — Internal Medicine, Clinical Cardiac ElectrophysiologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207RE0101X — Internal Medicine, Endocrinology, Diabetes & MetabolismPlain English: Board-Certified Endocrinologist (Diabetes, Thyroid & Hormone Specialist) | State: N/A | License: Verified | Primary: Secondary |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: N/A | License: Verified | Primary: Secondary |
207V00000X — Obstetrics & GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: N/A | License: Verified | Primary: Secondary |
207VX0201X — Obstetrics & Gynecology, Gynecologic OncologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: N/A | License: Verified | Primary: Secondary |
207X00000X — Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207Y00000X — OtolaryngologyPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology | State: N/A | License: Verified | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Secondary |
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: N/A | License: Verified | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: N/A | License: Verified | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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