Individual provider Active NPI

Roscoe Orlando Vancamp, M.D.

  • Family Medicine Physician
  • Minot, ND
National Provider Identifier
1417934563
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1638 Issued in AK
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

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
1638AKMDPharmacist
MD9415HIMDFamily Medicine Physician
17260NEMDFamily 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.

Verify at the official NPI Registry.