Individual provider Active NPI

Anthony James Vaughn, PHARM.D.

  • Pharmacist
  • Twin Falls, ID
National Provider Identifier
1558660431
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5276 Issued in ID
Practice address
705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007
Phone
(208) 736-5373
Fax
(208) 736-5367
NPI assigned
Mar 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5276 ID Primary

Addresses

Primary practice location

705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007

Mailing address

705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007
Phone (208) 736-5373

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
P5276IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1558660431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014007",
            "telephone_number": "208-736-5373",
            "fax_number": "208-736-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014007",
            "telephone_number": "208-736-5373",
            "fax_number": "208-736-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.