Active NPI
Robert Thomas Vaughn III, RN
- Emergency Registered Nurse
- O Fallon, MO
National Provider Identifier
1306459185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 2019003264
- Practice address
- 846 Brookmead Dr
O Fallon, MO 63366-7572 - Phone
- (314) 707-1700
- NPI assigned
- Aug 31, 2020
- 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 |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 2019003264 | MO | Primary |
Addresses
Primary practice location
846 Brookmead Dr
O Fallon, MO 63366-7572
Mailing address
846 Brookmead Dr
O Fallon, MO 63366-7572
Phone (314) 707-1700
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019003264 | MO | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1306459185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "846 BROOKMEAD DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633667572",
"telephone_number": "314-707-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "846 BROOKMEAD DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633667572",
"telephone_number": "314-707-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "ROBERT",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-31",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "MO",
"license": "2019003264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.