Organization Active NPI

Vaughn Podiatry Center PC

  • Foot Surgery Podiatrist
  • Montgomery, AL
National Provider Identifier
1457571713
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
213 Issued in AL
Legal business name
VAUGHN PODIATRY CENTER PC
Practice address
4709 Woodmere Blvd
Montgomery, AL 36106
Phone
(334) 277-3338
Fax
(334) 277-3357
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Dr. Hadryan Vaughn, DPMNPI 1275686305
Title
Owner
Phone
(334) 277-3338

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
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 213 AL Primary

Addresses

Primary practice location

4709 Woodmere Blvd
Montgomery, AL 36106

Mailing address

4709 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 277-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070503000122 AL Part B Supplier - Clinic/Group Practice 4284730599 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL
O20220506000340 AL Part B Supplier - Independent Clinical Laboratory 4284730599 Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

4709 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 277-3338

Practitioners & affiliated clinicians

Practitioners 1

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": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1457571713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-277-3338",
            "fax_number": "334-277-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-277-3338",
            "fax_number": "334-277-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAUGHN PODIATRY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "HADRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-277-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AL",
            "license": "213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.