Individual provider Active NPI

Rhonda Sulene Vaughn, RPT.

  • Physical Therapist
  • Villa Rica, GA
National Provider Identifier
1609933837
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002308 Issued in GA
Practice address
7136 Greenleaves CT
Villa Rica, GA 30180-7601
Phone
(770) 836-5251
Fax
(770) 214-0708
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

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
Physical Therapist 225100000X PT002308 GA Primary

Addresses

Primary practice location

7136 Greenleaves CT
Villa Rica, GA 30180-7601

Mailing address

7136 Greenleaves CT
Villa Rica, GA 30180-7601
Phone (770) 836-5251

Other identifiers 4

IdentifierTypeStateIssuer
340906OtherGAWELLCARE OF GEORGIA
127433OtherGAPEACH STATE HEALTH PLAN
10052061OtherGAAMERIGROUP
PT002308OtherGAPRACTICE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT002308GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609933837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 GREENLEAVES CT",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807601",
            "telephone_number": "770-836-5251",
            "fax_number": "770-214-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 GREENLEAVES CT",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807601",
            "telephone_number": "770-836-5251",
            "fax_number": "770-214-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "RHONDA",
        "middle_name": "SULENE",
        "credential": "RPT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT002308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF GEORGIA",
            "identifier": "340906",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE HEALTH PLAN",
            "identifier": "127433",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10052061",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE LICENSE",
            "identifier": "PT002308",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.