Active NPI
Robert Maurice Vaughn, DC
- Chiropractor
- Eden, NC
National Provider Identifier
1285690974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 828
- Practice address
- 405 Boone Rd
Eden, NC 27288 - Phone
- (336) 627-7398
- Fax
- (336) 627-8421
- NPI assigned
- Apr 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 828 | NC | Primary |
Addresses
Primary practice location
405 Boone Rd
Eden, NC 27288
Mailing address
PO Box 128
Eden, NC 27288
Phone (336) 627-7398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8908899 | Medicaid | NC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 828 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1285690974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 128",
"city": "EDEN",
"state": "NC",
"postal_code": "27288",
"telephone_number": "336-627-7398",
"fax_number": "336-627-8421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 BOONE RD",
"city": "EDEN",
"state": "NC",
"postal_code": "27288",
"telephone_number": "336-627-7398",
"fax_number": "336-627-8421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "ROBERT",
"middle_name": "MAURICE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-22",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "828",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8908899",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.