Individual provider Active NPI

Jason Patrick Vaughn, DC

  • Chiropractor
  • Dallas, GA
National Provider Identifier
1346445426
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007531 Issued in GA
Practice address
3754 Hiram Acworth Hwy Ste a
Dallas, GA 30157-3275
Phone
(770) 443-0090
NPI assigned
Jun 18, 2007
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007531 GA Primary

Addresses

Primary practice location

3754 Hiram Acworth Hwy Ste a
Dallas, GA 30157-3275

Mailing address

3754 Hiram Acworth Hwy Ste a
Dallas, GA 30157-3275
Phone (770) 443-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000159 GA Practitioner - Chiropractic 3274596838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

85 Golf Crest Dr
Suite 201
Acworth, GA 30101-2698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vaughn Chiropractic LLC Chiropractor CurrentSince May 27, 2016 Accepting new patients
Two Hands Chiropractic LLC Chiropractor PastSince Sep 28, 2011 Accepting new patients

Locations

85 Golf Crest Dr
Ste 201
Acworth, GA 30101
Phone (270) 993-5398

3754 Hiram Acworth Hwy
Ste A
Dallas, GA 30157
Phone (770) 430-0090

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1346445426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 HIRAM ACWORTH HWY STE A",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301573275",
            "telephone_number": "770-443-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 HIRAM ACWORTH HWY STE A",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301573275",
            "telephone_number": "770-443-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JASON",
        "middle_name": "PATRICK",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.