NPIMap

Individual provider Active NPI

Collin Vaughn, M.D.

  • Emergency Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1104933068
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7627 Issued in SD
Practice address
323 S Phillips Ave Apt 1
Sioux Falls, SD 57104-6305
Phone
(605) 376-1133
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 7627 SD Primary

Addresses

Primary practice location

323 S Phillips Ave Apt 1
Sioux Falls, SD 57104-6305

Mailing address

323 S Phillips Ave Apt 1
Sioux Falls, SD 57104-6305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX, IA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20091013000354 SD Practitioner - Emergency Medicine 4183760770 Reassigns benefits to 2 organizations
I20170518001346 TX Practitioner - Emergency Medicine 4183760770 Reassigns benefits to 5 organizations
I20210303002113 IA Practitioner - Emergency Medicine 4183760770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005
  • Avera Heart Hospital of South Dakota Hospital, Sioux Falls, SD, CCN 430095

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7627SDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital CurrentSince May 24, 2021 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Apr 8, 2017 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince May 25, 2011 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 8, 2017 Accepting new patients
Avera McKennan Current Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 8, 2017 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince May 25, 2011 Accepting new patients
Spencer Municipal Hospital CurrentSince May 24, 2021 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Interoperability endpoints

  • Direct secure messaging: collin.vaughn.1@16187.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1104933068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S PHILLIPS AVE APT 1",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S PHILLIPS AVE APT 1",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046305",
            "telephone_number": "605-376-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "COLLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "7627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.