Active NPI
Adrianne Dewalt Vaughn, M.D.
- Allergy Physician
- San Antonio, TX
National Provider Identifier
1649263740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- J1970
- Practice address
- 115 Gallery Cir Ste 200
San Antonio, TX 78258-3492 - Phone
- (210) 499-0033
- Fax
- (210) 404-0926
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | J1970 | TX | Primary |
Addresses
Primary practice location
115 Gallery Cir Ste 200
San Antonio, TX 78258-3492
Mailing address
21314 W Tejas TRL
San Antonio, TX 78257-1691
Phone (210) 326-3187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167437601 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 25, 2023 through Nov 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J1970 | TX | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alamo Asthma & Allergy Associates, P.a. | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 1
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.
-
- Specialist
- San Antonio, TX
- NPI 1104981315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700870400000",
"number": "1649263740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21314 W TEJAS TRL",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782571691",
"telephone_number": "210-326-3187",
"fax_number": "210-404-0926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 GALLERY CIR STE 200",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782583492",
"telephone_number": "210-499-0033",
"fax_number": "210-404-0926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "ADRIANNE",
"middle_name": "DEWALT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-24",
"last_updated": "2023-11-25",
"certification_date": "2023-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "TX",
"license": "J1970",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "167437601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.