Active NPI
Eva Marie Kasbohm, PHARMD
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1497024996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302042301
- Practice address
- 1964 Fuller Ave NE
Grand Rapids, MI 49505-4861 - Phone
- (616) 364-7071
- NPI assigned
- Dec 29, 2011
- Last updated
- Jan 8, 2016
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302042301 | MI | Primary |
Addresses
Primary practice location
1964 Fuller Ave NE
Grand Rapids, MI 49505-4861
Mailing address
1605 E Kentview Dr NE
Grand Rapids, MI 49505-4872
Phone (415) 832-0777
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042301 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1497024996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 E KENTVIEW DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495054872",
"telephone_number": "415-832-0777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1964 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495054861",
"telephone_number": "616-364-7071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASBOHM",
"first_name": "EVA",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-29",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302042301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.