Organization Active NPI

Jenna Vaught LLC

  • Podiatrist
  • Nicholasville, KY
National Provider Identifier
1447787676
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
JENNA VAUGHT LLC
Practice address
801 E Brannon Rd Unit 322
Nicholasville, KY 40356-6095
Phone
(502) 438-7739
NPI assigned
May 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Authorized official

Name
Dr. Jenna Beth Vaught, DPMNPI 1700174604
Title
Owner of Private Practice
Phone
(502) 438-7739

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

801 E Brannon Rd Unit 322
Nicholasville, KY 40356-6095

Mailing address

PO Box 910216
Lexington, KY 40591-0216
Phone (502) 438-7739

Other identifiers 3

IdentifierTypeStateIssuer
7100297720MedicaidKY
1700174604OtherNPI
1447787676OtherNPI2 DRJENNA VAUGHT LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170811001299 KY Part B Supplier - Clinic/Group Practice 3072884881 Receives reassigned benefits from 1 practitioner
Practice locations: Ashland, KY; Versailles, KY; Somerset, KY; Sheperdsville, KY; Shelbyville, KY; Sanders, KY; Owensboro, KY; Nicholasville, KY…

National Provider Directory

National Provider Directory

Locations

101 Isaac Greer Ct
Bardstown, KY 40004
Phone (502) 348-6214

100 W Broad St
Central City, KY 42330

1505 Stadium View Dr
Murray, KY 42071
Phone (270) 753-7109

100 Williamsburg Dr
Shelbyville, KY 40065
Phone (502) 257-9485

1516 Highway 44 E
Shepherdsville, KY 40165
Phone (502) 543-7042

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1447787676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910216",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405910216",
            "telephone_number": "502-438-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E BRANNON RD UNIT 322",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403566095",
            "telephone_number": "502-438-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNA VAUGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER OF PRIVATE PRACTICE",
        "authorized_official_telephone_number": "502-438-7739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100297720",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700174604",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI2 DRJENNA VAUGHT LLC",
            "identifier": "1447787676",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.