Active NPI
Katherine Rose Bellesheim, PH.D.
- Clinical Psychologist
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301019431
- Practice address
- 235 Wealthy St SE
Grand Rapids, MI 49503-5247 - Phone
- (616) 840-8668
- Fax
- (616) 840-9762
- NPI assigned
- Dec 30, 2019
- Last updated
- Feb 3, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS02069 | RI | |
| Clinical Psychologist | 103TC0700X | 6301019431 | MI | Primary |
Addresses
Primary practice location
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Mailing address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-8668
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kbellesheim163326@direct.covenanthealthcare.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
235 Wealthy St SE
Grand Rapids, MI 49503-5229
Phone (616) 840-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301019431 | MI | MD | Clinical Psychologist |
| PS02069 | RI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group, Inc. | Psychologist | Current | Accepting new patients |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Mary Free Bed Rehabilitation Hospital | Current | Accepting new patients | |
| Mary Free Bed Rehabiltation Hospital | Current | Accepting new patients | |
| Mary Free Bed Rehabilitation Hospital | Past | Accepting new patients | |
| Indian Health Care Resource Center | Past | Accepting new patients | |
| Indian Health Care Resource Center of Tulsa, Inc. | Past | Accepting new patients |
Locations
235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
593 Eddy St
Providence, RI 02903
593 Eddy St
Ste 430
Providence, RI 02903
Phone (401) 444-4500
1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rehabilitation Hospital
- Grand Rapids, MI
- NPI 1730133463
-
dba Brown Health Medical Group
- Psychiatry Physician
- Providence, RI
- NPI 1548506793
Psychologist
-
dba Mary Free Bed Rehabilitation Hospital
- Physical Medicine & Rehabilitation Physician
- Grand Rapids, MI
- NPI 1932372919
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
-
dba Mary Free Bed Medical Group
- Physical Medicine & Rehabilitation Physician
- Grand Rapids, MI
- NPI 1053641589
-
- Clinic/Center
- Tulsa, OK
- NPI 1427034958
-
- Pharmacy
- Tulsa, OK
- NPI 1457447609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738540800000",
"number": "1508405275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035247",
"telephone_number": "616-840-8668",
"fax_number": "616-840-9762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035247",
"telephone_number": "616-840-8668",
"fax_number": "616-840-9762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLESHEIM",
"first_name": "KATHERINE",
"middle_name": "ROSE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2025-02-03",
"certification_date": "2025-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS02069",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301019431",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kbellesheim163326@direct.covenanthealthcare.com",
"affiliation": "N",
"address_1": "235 Wealthy St SE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495035247",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.