Individual provider Active NPI

Ryne Gage Vaughn, RDN

  • Registered Dietitian
  • Cleburne, TX
National Provider Identifier
1386489789
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT87937 Issued in TX
Practice address
1924 Albany LN
Cleburne, TX 76033-4772
Phone
(806) 632-7976
NPI assigned
Jun 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT87937 TX Primary

Addresses

Primary practice location

1924 Albany LN
Cleburne, TX 76033-4772

Mailing address

1924 Albany LN
Cleburne, TX 76033-4772
Phone (806) 632-7976

Other practice location 1

7300 Bosque Blvd
Waco, TX 76710-4023
Phone (254) 202-2638

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

LicenseStateTypeSpecialty
DT87937TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1386489789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALBANY LN",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334772",
            "telephone_number": "806-632-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALBANY LN",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334772",
            "telephone_number": "806-632-7976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 Bosque Blvd",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767104023",
            "country_code": "US",
            "telephone_number": "254-202-2638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "RYNE",
        "middle_name": "GAGE",
        "name_prefix": "Mr.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT87937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.