Organization Active NPI

DRS Peter and Lisa Hogenkamp PC

  • Family Medicine Physician
  • Rutland, VT
National Provider Identifier
1679636765
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DRS PETER AND LISA HOGENKAMP PC
Practice address
10 Commons St
Rutland, VT 05701-4651
Phone
(802) 747-3359
Fax
(802) 786-5204
NPI assigned
Dec 19, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Lisa M Hogenkamp, M.D.NPI 1225073737
Title
MD
Phone
(802) 747-3359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D0964783DRS Peter and Lisa Hogenkamp10 Commons Street, Rutland, VT 05701Certificate of waiverSep 1, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20070220000451 VT Part B Supplier - Clinic/Group Practice 3678675766 Receives reassigned benefits from 6 practitioners
Practice locations: Rutland, VT

National Provider Directory

National Provider Directory

Locations

10 Commons St
Rutland, VT 05701
Phone (802) 432-8445

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

10 Commons St
Rutland, VT 05701-4651

Mailing address

10 Commons St
Rutland, VT 05701-4651
Phone (802) 747-3359

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 21, 2020.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1679636765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-747-3359",
            "fax_number": "802-786-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-747-3359",
            "fax_number": "802-786-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS PETER AND LISA HOGENKAMP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "HOGENKAMP",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "802-747-3359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.