Emily Fowler Bemben, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6704 Issued in MN

Practice address

72 Sheldon Ave SE
Grand Rapids, MI 49503-4234

Phone

(616) 331-9830

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8784/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Burke Group Counseling & Consulting Professionals LLC

  • Clinical Social Worker
  • Grandville, MI
  • NPI 1639593627
  Medicare reassignment NPD
• Lyn-Lake Psychotherapy and Wellness LTD.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1609355163
  Medicare reassignment NPD
• Native American Community Clinic

  • Public Health or Welfare Agency
  • Minneapolis, MN
  • NPI 1932258845
  Medicare reassignment NPD
• Native American Community Clinic

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1730366600
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1760897375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SHELDON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034234",
            "telephone_number": "650-814-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SHELDON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034234",
            "telephone_number": "616-331-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "485 N 1st St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951124067",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1213 E Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55404",
            "country_code": "US",
            "telephone_number": "612-872-8086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEMBEN",
        "first_name": "EMILY",
        "middle_name": "FOWLER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2475459",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Belmonte, MSW LMSW
• Angela Belsito-Fantin
• Carolyn A Belsito, REGISTERED DIETICIAN
• Ricky Belton Jr.
• Rhoda Valdez Beltran, MD
• Kathryn Irene Benavides, N.P.
• Perla Benavides
• Eunice Benavidez, LLMSW
• Nancy Bender Hausman
• Brittany Anne Bendiksen

• Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.