Individual provider Active NPI

Amanda Vaughn Saunders, D.O.

  • General Practice Physician
  • Durham, NC
National Provider Identifier
1013279017
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
184104 Issued in NC
Practice address
55 TW Alexander Dr
Office
Durham, NC 27709-0152
Phone
(919) 425-5479
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 184104 NC Primary

Addresses

Primary practice location

55 TW Alexander Dr
Office
Durham, NC 27709-0152

Mailing address

10540 Bedfordtown Dr
Private Address
Raleigh, NC 27614-8069
Phone (919) 780-8423

Other names 1

  • Amanda Audrey Vaughn Former name

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
184104NCMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1013279017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 BEDFORDTOWN DR",
            "address_2": "PRIVATE ADDRESS",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148069",
            "telephone_number": "919-780-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TW ALEXANDER DR",
            "address_2": "OFFICE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277090152",
            "telephone_number": "919-425-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "AMANDA",
        "middle_name": "VAUGHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "184104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "VAUGHN",
            "middle_name": "AUDREY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.