Active NPI
DRS Peter and Lisa Hogenkamp PC
- Family Medicine Physician
- Rutland, VT
National Provider Identifier
1679636765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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.
- 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 47D0964783 | DRS Peter and Lisa Hogenkamp | Certificate of waiver | Sep 1, 2027 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070220000451 | VT | Part B Supplier - Clinic/Group Practice | 3678675766 |
Receives reassigned benefits from 6 practitioners Practice locations: Rutland, VT |
National Provider Directory
National Provider DirectoryLocations
10 Commons St
Rutland, VT 05701
Phone (802) 432-8445
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
NPPES NPI RegistryPrimary 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.