Organization Active NPI

R. Bauer Vaughters, III, MD, Inc.

  • Specialist
  • Aiken, SC
National Provider Identifier
1427175108
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
22809 Issued in SC
Legal business name
R. BAUER VAUGHTERS, III, MD, INC.
Practice address
526 Richland Ave W
Aiken, SC 29801-3828
Phone
(803) 648-3130
Fax
(803) 648-9860
NPI assigned
Mar 26, 2007
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Mrs. Deedee Hardee Vaughters
Title
Practice Manager
Phone
(803) 648-3130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 22809 SC Primary

Addresses

Primary practice location

526 Richland Ave W
Aiken, SC 29801-3828

Mailing address

PO Box 1132
Aiken, SC 29802-1132
Phone (803) 648-3130

Other identifiers 1

IdentifierTypeStateIssuer
228097MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518000515 SC Part B Supplier - Clinic/Group Practice 7214927441 Receives reassigned benefits from 4 practitioners
Practice locations: Aiken, SC

National Provider Directory

National Provider Directory

Locations

39 Varden Dr
Ste C
Aiken, SC 29803
Phone (803) 648-3130

526 Richland Ave W
Aiken, SC 29801
Phone (803) 648-3130

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1427175108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1132",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298021132",
            "telephone_number": "803-648-3130",
            "fax_number": "803-648-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 RICHLAND AVE W",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013828",
            "telephone_number": "803-648-3130",
            "fax_number": "803-648-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. BAUER VAUGHTERS, III, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "VAUGHTERS",
        "authorized_official_first_name": "DEEDEE",
        "authorized_official_middle_name": "HARDEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "803-648-3130",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "22809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228097",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.