Vintage Direct Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00033623 Issued in WA

Legal business name

VINTAGE DIRECT PRIMARY CARE

Practice address

19319 7TH Ave NE Ste 114
Poulsbo, WA 98370-7442

Phone

(360) 930-3500

Fax

(866) 480-7382

NPI assigned

Jul 15, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Peter Michael Lehmann, MDNPI 1407899362

Title

Owner

Phone

(360) 930-3500

Specialties & licenses 1

Addresses

Tax ID family

Vintage Direct Primary Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vintage Direct Primary Care

  • Family Medicine Physician
  • Kingston, WA
  • NPI 1912423468
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Michael Lehmann, MD

  • Family Medicine Physician
  • Poulsbo, WA
  • NPI 1407899362
  NPD Authorized official

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

{
    "created_epoch": "1500076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023530573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE STE 114",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-930-3500",
            "fax_number": "866-480-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE STE 114",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-930-3500",
            "fax_number": "866-480-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE DIRECT PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEHMANN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-930-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00033623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ullrich
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• Ruth Urand
• James A Van, PA-C
• Rebekah E Verdugo, LICSW, LCSW, SUDP
• Virginia E Swanson MD PLLC
• Shannon Foster Vitone
• Matthew A Voorsanger, MD
• Wagner Family Wellness Center LLC
• Blake Joseph Wagner, D.C.

• Family Medicine Physician in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.