Active NPI
Kathy J. Bellemore, NP
- Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1447443635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704172326
- Practice address
- 4062 W Royal Dr
Traverse City, MI 49684-8965 - Phone
- (231) 935-0338
- NPI assigned
- Aug 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704172326 | MI | Primary |
Addresses
Primary practice location
4062 W Royal Dr
Traverse City, MI 49684-8965
Mailing address
4062 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5008707120 | Other | MI | BCBS PIN NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1447443635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4062 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-935-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4062 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-935-0338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLEMORE",
"first_name": "KATHY",
"middle_name": "J.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-22",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704172326",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN NUMBER",
"identifier": "5008707120",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.