Active NPI
John Foster Hoefer, MD
- Family Medicine Physician
- South Lake Tahoe, CA
National Provider Identifier
1760467997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G42278
- Practice address
- 2130 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6405 - Phone
- (530) 541-3277
- Fax
- (530) 541-6913
- NPI assigned
- Dec 9, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G42278 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 11721 | NV |
Addresses
Primary practice location
2130 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6405
Mailing address
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659
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 |
|---|---|---|---|
| 42278 | CA | MD | General Practice Dentistry |
| 11721 | NV | MD | Pharmacist |
| G42278 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1760467997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EMERALD BAY RD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961506207",
"telephone_number": "530-543-5659",
"fax_number": "530-541-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 LAKE TAHOE BLVD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961506405",
"telephone_number": "530-541-3277",
"fax_number": "530-541-6913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOEFER",
"first_name": "JOHN",
"middle_name": "FOSTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G42278",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "11721",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.