Vintage Direct Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00033623 Issued in WA

Legal business name

VINTAGE DIRECT PRIMARY CARE

Practice address

25985 Barbr Cutff Rd NE Ste B1
Kingston, WA 98346-9596

Phone

(360) 860-3020

NPI assigned

Aug 16, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Peter Michael Lehmann, MDNPI 1407899362

Title

Owner

Phone

(360) 860-3020

Specialties & licenses 1

Addresses

Tax ID family

Vintage Direct Primary Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vintage Direct Primary Care

  • Family Medicine Physician
  • Poulsbo, WA
  • NPI 1023530573
  NPD tax ID

Practitioners 1

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

• Peter Michael Lehmann, MD

  • Family Medicine Physician
  • Poulsbo, WA
  • NPI 1407899362
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502841600000",
    "number": "1912423468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19319 7TH AVE NE STE 114",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707442",
            "telephone_number": "360-930-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25985 BARBR CUTFF RD NE STE B1",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469596",
            "telephone_number": "360-860-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE DIRECT PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A",
        "authorized_official_last_name": "LEHMANN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-860-3020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00033623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Kingston, WA
• Providers in Kingston, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.