Individual provider Active NPI

Charles H Vaughn, D.P.M.

  • Podiatrist
  • Denver, CO
National Provider Identifier
1164573531
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
435 Issued in CO
Practice address
8335 Fairmount Drive
BLDG 2, Unit 207
Denver, CO 80247
Phone
(303) 370-2271
Fax
(303) 830-0545
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 435 CO Primary

Addresses

Primary practice location

8335 Fairmount Drive
BLDG 2, Unit 207
Denver, CO 80247

Mailing address

8335 Fairmount Drive
BLDG 2, Unit 207
Denver, CO 80247
Phone (303) 370-2271

Other identifiers 1

IdentifierTypeStateIssuer
01004357MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000736 CO Practitioner - Podiatry 9032177738 Practice locations: Yuma, CO; Denver, CO; Brush, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
435COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1164573531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8335 FAIRMOUNT DRIVE",
            "address_2": "BLDG 2, UNIT 207",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80247",
            "telephone_number": "303-370-2271",
            "fax_number": "303-830-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8335 FAIRMOUNT DRIVE",
            "address_2": "BLDG 2, UNIT 207",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80247",
            "telephone_number": "303-370-2271",
            "fax_number": "303-830-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "CHARLES",
        "middle_name": "H",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004357",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.