Active NPI
Roscoe Orlando Vancamp, M.D.
- Family Medicine Physician
- Minot, ND
National Provider Identifier
1417934563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1638
- Practice address
- 10 Missile Ave
Minot, ND 58705-5003 - Phone
- (701) 723-5633
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD9415 | HI | |
| Family Medicine Physician | 207Q00000X | 17260 | NE | |
| Family Medicine Physician | 207Q00000X | 1638 | AK | Primary |
Addresses
Primary practice location
10 Missile Ave
Minot, ND 58705-5003
Mailing address
76 Alpine Ave
Jber, AK 99505-1021
Phone (907) 750-5071
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1638 | AK | MD | Pharmacist |
| MD9415 | HI | MD | Family Medicine Physician |
| 17260 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1417934563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 ALPINE AVE",
"city": "JBER",
"state": "AK",
"postal_code": "995051021",
"telephone_number": "907-750-5071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MISSILE AVE",
"city": "MINOT",
"state": "ND",
"postal_code": "587055003",
"telephone_number": "701-723-5633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCAMP",
"first_name": "ROSCOE",
"middle_name": "ORLANDO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "HI",
"license": "MD9415",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "17260",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "1638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.