Active NPI
Daran Vaughan Gaines
- Physician Assistant
- Des Moines, IA
National Provider Identifier
1629771977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9119118
- Practice address
- 3200 Grand Ave
Des Moines, IA 50312-4104 - Phone
- (515) 271-1569
- NPI assigned
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA9119118 | FL | Primary |
Addresses
Primary practice location
3200 Grand Ave
Des Moines, IA 50312-4104
Mailing address
1240 County Road 2340
Moberly, MO 65270-4323
Phone (573) 397-1821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9119118 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America LLC | Current | Accepting new patients | |
| Cep America LLC | Current | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603
Interoperability endpoints
- daran.gaines@716881743511556.direct.elationemr.com
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Miramar Beach, FL
- NPI 1295442614
-
- Emergency Medicine Physician
- Aventura, FL
- NPI 1043917180
-
- Emergency Medicine Physician
- Middleburg, FL
- NPI 1699462689
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1629771977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1240 COUNTY ROAD 2340",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652704323",
"telephone_number": "573-397-1821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503124104",
"telephone_number": "515-271-1569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAINES",
"first_name": "DARAN",
"middle_name": "VAUGHAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-24",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9119118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.