Individual provider Active NPI

Jason Vaughan, DO

  • Emergency Medicine Physician
  • Evansville, IN
National Provider Identifier
1487731899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34-008428 Issued in OH
Practice address
3700 Washington Ave
Evansville, IN 47750-0001
Phone
(330) 493-4443
Fax
(330) 493-8677
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34-008428 OH Primary

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47750-0001

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000278 IN Practitioner - Emergency Medicine 7810923505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Memorial Medical Center IncGroup PAC ID 4587578042, 140 clinicians

Practice addresses (Care Compare)

800 W 9TH St
Jasper, IN 47546-2514
Phone (812) 996-0188

Hospital & facility affiliations

  • Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-008428OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Memorial Medical Center Inc CurrentSince Feb 2, 2008 Accepting new patients
Deaconess Memorial Medical Center Inc Emergency Medicine CurrentSince Feb 2, 2008 Accepting new patients
Deaconess Memorial Medical Center Inc Emergency Medicine Current Accepting new patients
Emergency Medicine Physicians of Vanderburgh County, PC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Pasquotank County, PLLC Emergency Medicine Past Accepting new patients
Lucas County Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Locations

600 W 13th St
Ste 100
Jasper, IN 47546
Phone (812) 996-2345

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

Interoperability endpoints

  • Direct secure messaging: jvaughan18392@direct.mhhcc.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487731899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "JASON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-008428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.