Paul Vaughn, SCAT, ATC, OPE-C

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATH.J00202 Issued in LA

Practice address

1 Falcon Drive
Columbia, SC 29204

Phone

(803) 738-7300

NPI assigned

Jan 20, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1093172199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 CANALSIDE ST UNIT 1008",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292016029",
            "telephone_number": "318-376-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FALCON DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-738-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "SCAT, ATC, OPE-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "SC532593",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.J00202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Vaughan, M.D.
• Zandra Chinae Vaughan, MSW, LISW
• Vaughn Physical Therapy, LLC
• Javan Bozard Vaughn, MSN, FNP-C
• Mary Giovanetti Vaughn, RPH
• Robert Vaughn II, PHARMD.
• Santita Vaughn
• Ulandy Marie Vaughn, PTA
• Marcus Owen Vaught, M.D.
• Raven Symone Vaught, LISW-CP

• Athletic Trainer in Columbia, SC
• Providers in Columbia, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.