Jordan Vaughan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MED-PHYS-LIC-112709 Issued in MT

Practice address

310 Sunnyview LN
Kalispell, MT 59901-3129

Phone

(406) 751-5310

Fax

(406) 751-3068

NPI assigned

Apr 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org

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

• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• Kalispell Regional Medical Center Inc

  • General Acute Care Hospital
  • Kalispell, MT
  • NPI 1417945627
  Medicare reassignment NPD (past)
• Kalispell Regional Medical Center Inc

  • Clinic/Center
  • Kalispell, MT
  • NPI 1235333139
  NPD
• Kalispell Regional Medical Center, Inc

  • Radiology Clinic/Center
  • Whitefish, MT
  • NPI 1073362463
  NPD
• Kalispell Regional Medical Center, Inc.

  • Surgery Physician
  • Kalispell, MT
  • NPI 1972748127
  NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• University of Utah Pediatric Services

  • Pediatric Urology Physician
  • Salt Lake City, UT
  • NPI 1568826311
  NPD
• Kalispell Regional Medical Center, Inc

  • Surgery Physician
  • Kalispell, MT
  • NPI 1215527403
  NPD (past)

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1386141083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BLUE SPRUCE LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599016830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-751-5310",
            "fax_number": "406-751-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "MED-PHYS-LIC-112709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Leanne Vancurler
• Ezekiel Michael Vandehei, PCLC
• Andrea Vander Ark, M.S., CCC-SLP
• Mark Allen Vanzant, DMD
• C. Read Vaughan, M.D.
• Turea Venner, MAT, LAT, ATC
• Rhonda Vick, LCSW
• Victor C. Houser M.D.P.C.
• Samantha Lynn Vincent, SWLC
• Vision Clinic PLLC

• Pediatrics Physician in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Pediatrics Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.