NPIMap

Individual provider Active NPI

Vincent Vaughn, D.O.

  • Internal Medicine Physician
  • Pueblo, CO
National Provider Identifier
1134660400
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0062724 Issued in CO
Practice address
311 W 14TH St
Pueblo, CO 81003-2705
Phone
(719) 595-7585
Fax
(719) 595-7982
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TL.0006401 CO
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X DR.0062724 CO Primary

Addresses

Primary practice location

311 W 14TH St
Pueblo, CO 81003-2705

Mailing address

311 W 14TH St
Pueblo, CO 81003-2705
Phone (719) 595-7585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200723003705 CO Practitioner - Hospitalist 5092052159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1750 E Ken Pratt Blvd
Uchealth
Longmont, CO 80504-5311
Phone (970) 237-7848

1760 E Ken Pratt Blvd
Longmont, CO 80504-5311

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • Spanish Peaks Regional Health Center Hospital, Walsenburg, CO, CCN 061316
  • Mt San Rafael Hospital Hospital, Trinidad, CO, CCN 061321
  • Arkansas Valley Regional Medical Center Hospital, Lajuna, CO, CCN 061336

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0062724COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Single Specialty CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Single Specialty CurrentSince Jun 1, 2025 Accepting new patients
Pueblo Pathology Group, PC Single Specialty Current Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

311 W 14th St
Pueblo, CO 81003
Phone (719) 595-7585

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1134660400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 14TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032705",
            "telephone_number": "719-595-7585",
            "fax_number": "719-595-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 14TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032705",
            "telephone_number": "719-595-7585",
            "fax_number": "719-595-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "VINCENT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "TL.0006401",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0062724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.