Vaughn Thad Johnson, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9531048-1204 Issued in UT

Practice address

3650 N University Ave Ste 200
Provo, UT 84604-6658

Phone

(801) 375-7100

Fax

(801) 375-7102

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Specialty

Family Practice

Education

University of Utah School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powell County Memorial Hospital Association Inc.Group PAC ID 6103734728, shared by 2 NPIs, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deer Lodge Medical Center Hospital, Deer Lodge, MT, CCN 271314
• Deer Lodge Medical Center Nursing home, CCN 27Z314

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vjohnson999586@wm.providencedirect.org

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.

• Powell County Memorial Hospital Association Inc

  • Critical Access Hospital
  • Deer Lodge, MT
  • NPI 1275560617
  Medicare reassignment NPD
• Powell County Memorial Hospital Association Inc

  • Family Medicine Physician
  • Deer Lodge, MT
  • NPI 1841414026
  Medicare reassignment NPD
• Mountain Peaks Family Practice LC

  • Health Service Clinic/Center
  • Orem, UT
  • NPI 1023263969
  NPD (past)

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

• Powell County Memorial Hospital Association Inc

  • Critical Access Hospital
  • Deer Lodge, MT
  • NPI 1275560617
  Care Compare affiliation

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1659453694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046658",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046658",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VAUGHN",
        "middle_name": "THAD",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9531048-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Hap Johnson, PA-C
• Tiffany Jean Johnson
• Toby Johnson, MD
• Valerie A Johnson, PHARMD
• Vance Bradley Johnson, M.D.
• Wendy A Johnson, APRN
• Megan Linda Johnston
• Ashley Johstoneaux, MFTI
• Jessica Johstoneaux
• Pamela Johstoneaux, LCSW

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.