Individual provider Active NPI

Elizabeth Vaughan

  • Physical Therapist
  • Greenville, TX
National Provider Identifier
1013305622
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1037984 Issued in TX
Practice address
4501 Joe Ramsey Blvd E
Suite 130
Greenville, TX 75401-7836
Phone
(903) 455-7538
Fax
(903) 455-7548
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1037984 TX Primary

Addresses

Primary practice location

4501 Joe Ramsey Blvd E
Suite 130
Greenville, TX 75401-7836

Mailing address

331 Shepards Hill Dr
Rockwall, TX 75087-2850
Phone (214) 577-5205

Other identifiers 1

IdentifierTypeStateIssuer
1037984OtherTXLISENCE

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

State licenses

LicenseStateTypeSpecialty
1037984TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1013305622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SHEPARDS HILL DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872850",
            "telephone_number": "214-577-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 JOE RAMSEY BLVD E",
            "address_2": "SUITE 130",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017836",
            "telephone_number": "903-455-7538",
            "fax_number": "903-455-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1037984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISENCE",
            "identifier": "1037984",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.