DR. KIPP ALLEN VANCAMP (DO) – Diagnostic Radiology Physician, NPI 1164460655
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
217 INTERVENTIONAL RADIOLOGY in GA
Provider Addresses for DR. KIPP ALLEN VANCAMP (DO)
604 LOVEJOY LN STE 100
WOODSTOCK, GA 301893634
Phone: (770) 268-4336
Fax: (470) 251-6063
Type: Location
22740 Midland Dr
Shawnee, KS 662263553
Phone: (913) 745-5300
Fax: (913) 745-5530
Type: Location
3333 RIVERWOOD PKWY SE STE 250
ATLANTA, GA 303393304
Phone: (770) 914-0116
Fax: (770) 955-4278
Type: Mailing
Hilltop Road, Shawnee County, Kansas, United States
SHAWNEE, KS 662263571
Phone: (913) 745-5300
Fax: (253) 292-2090
Type: Mailing
Hilltop Road, Wabaunsee County, Kansas, United States
SHAWNEE, KS 662263571
Phone: (913) 745-5300
Fax: (253) 292-2090
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050502000427 | I | Diagnostic Radiology | KS | TBD |
| I20250424000635 | I | Diagnostic Radiology | GA | TBD |
| I20250811003300 | I | Interventional Radiology | MO | TBD |
| I20251106002987 | I | Diagnostic Radiology | MT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 474 | 474 | $0 |
| 77063 | Screening 3d breast mammography | 439 | 439 | $0 |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 115 | 58 | $0 |
| 71046 | X-ray of chest, 2 views | 88 | 87 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 74 | 70 | $0 |
Insurance plans in this area (ZIP 30189)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | KS | 62311 | Injections of substances into lower or sacral spine | 51 | 32 |
| DIAGNOSTIC RADIOLOGY | KS | 71010 | X-ray of chest, 1 view, front | 190 | 138 |
| DIAGNOSTIC RADIOLOGY | KS | 73562 | X-ray of knee, 3 views | 43 | 37 |
| DIAGNOSTIC RADIOLOGY | KS | 73630 | X-ray of foot, minimum of 3 views | 35 | 31 |
| DIAGNOSTIC RADIOLOGY | KS | 93926 | Ultrasound study of arteries and arterial grafts of one leg or limited | 14 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine, Internal Medicine | MO | |
| Internal Medicine | MO | |
| - | MO | |
| Orthopedic Surgery | MO | |
| N E U R O L O G Y | MO | |
| Hospitalist, Pediatric Medicine | MO | |
| Internal Medicine, Hospice/Palliative Care | MO | |
| Emergency Medicine | MO | |
| Emergency Medicine | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO |
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