Individual provider Active NPI

Jennifer Vaughn Sartor, M.D.

  • Anesthesiology Physician
  • Melbourne, FL
National Provider Identifier
1336341346
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME 97997 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901-3278
Phone
(321) 434-7000
NPI assigned
Jun 1, 2007
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME 97997 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901-3278

Mailing address

PO Box 2400
Melbourne, FL 32902-2400
Phone (321) 255-9671

Other identifiers 1

IdentifierTypeStateIssuer
ME97997OtherFLMEDICAL LICENSE

Other names 1

  • Dr. Jennifer Ruth Vaughn Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL N/A Other
Other URL N/A Other

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Stingl Family Foundation, Inc PastSince May 7, 2016 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1336341346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329022400",
            "telephone_number": "321-255-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013278",
            "telephone_number": "321-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARTOR",
        "first_name": "JENNIFER",
        "middle_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME 97997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME97997",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "1775 W Hibiscus Blvd Ste 215",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329012627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "1775 W Hibiscus Blvd Ste 215",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329012627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VAUGHN",
            "middle_name": "RUTH",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.

Verify at the official NPI Registry.