Individual provider Active NPI

Kelly Van Kampen, ATC

  • Athletic Trainer
  • Rockford, MI
National Provider Identifier
1922847516
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601001075 Issued in MI
Practice address
6637 Gran Via Dr NE
Rockford, MI 49341-9689
Phone
(616) 485-2183
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601001075 MI Primary

Addresses

Primary practice location

6637 Gran Via Dr NE
Rockford, MI 49341-9689

Mailing address

6637 Gran Via Dr NE
Rockford, MI 49341-9689
Phone (616) 485-2183

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

State licenses

LicenseStateTypeSpecialty
2601001075MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1922847516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6637 GRAN VIA DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419689",
            "telephone_number": "616-485-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 GRAN VIA DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419689",
            "telephone_number": "616-485-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KAMPEN",
        "first_name": "KELLY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.