Active NPI
Jennifer Vaught, O.D.
- Optometrist
- Kenner, LA
National Provider Identifier
1033204128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1376-508T
- Practice address
- 300 W Esplanade Ave
Kenner, LA 70065-2540 - Phone
- (504) 464-4153
- Fax
- (504) 464-9949
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1376-508T | LA | Primary |
Addresses
Primary practice location
300 W Esplanade Ave
Kenner, LA 70065-2540
Mailing address
300 W Esplanade Ave
Kenner, LA 70065-2540
Phone (504) 464-4153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1099155 | Medicaid | LA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1376-508T | LA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Columbian Optical Company | Past | Accepting new patients | |
| Orthotennessee, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223942400000",
"number": "1033204128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W ESPLANADE AVE",
"city": "KENNER",
"state": "LA",
"postal_code": "700652540",
"telephone_number": "504-464-4153",
"fax_number": "504-464-9949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W ESPLANADE AVE",
"city": "KENNER",
"state": "LA",
"postal_code": "700652540",
"telephone_number": "504-464-4153",
"fax_number": "504-464-9949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHT",
"first_name": "JENNIFER",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2008-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "LA",
"license": "1376-508T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1099155",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.