Individual provider Active NPI

Jaimee Michelle Kamp, NP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1346631496
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005385A Issued in IN
Practice address
1815 E Ireland Rd
South Bend, IN 46614-2845
Phone
(574) 647-1700
Fax
(574) 647-7572
NPI assigned
Feb 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28139876A IN
Nurse Practitioner 363L00000X 71005385A IN
Family Nurse Practitioner 363LF0000X 71005385A IN Primary

Addresses

Primary practice location

1815 E Ireland Rd
South Bend, IN 46614-2845

Mailing address

3245 Health Drive
Suite 100
Granger, IN 46530-3245
Phone (574) 647-1840

Other practice location 1

2102 N Main Street
Nappanee, IN 46550-9310
Phone (574) 862-2165

Other identifiers 1

IdentifierTypeStateIssuer
201282240MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmkamp@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150417000108 IN Practitioner - Nurse Practitioner 6204154503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1701 S Main St
Goshen, IN 46526-4723
Phone (574) 364-2875

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28139876AINMDRegistered Nurse
71005385AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Bend Emergency Physicians, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

615 N Michigan St
Ste Ecc
South Bend, IN 46601

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1346631496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DRIVE",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465303245",
            "telephone_number": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-647-1700",
            "fax_number": "574-647-7572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2102 N Main Street",
            "address_purpose": "LOCATION",
            "city": "Nappanee",
            "state": "IN",
            "postal_code": "465509310",
            "country_code": "US",
            "telephone_number": "574-862-2165",
            "fax_number": "574-862-4112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMP",
        "first_name": "JAIMEE",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28139876A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005385A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005385A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201282240",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmkamp@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1815 E Ireland Rd",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466142845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.