{
"Npi": {
"NPI": "1780191841",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KAMPS",
"FirstName": "CASEY",
"MiddleName": "MARIE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KETCHUM",
"OtherFirstName": "CASEY",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5838 METRO WAY SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WYOMING",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49519-9619",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5838 METRO WAY SW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WYOMING",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49519-9619",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-249-5300",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/10/2018",
"LastUpdateDate": "03/14/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1835P2201X",
"TaxonomyName": "Ambulatory Care Pharmacist",
"LicenseNumber": "5302039385",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}