Jeremy Tyler Vaughn

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3606 N Rancho Dr Ste 102
Las Vegas, NV 89130-3196

Phone

(702) 800-1929

NPI assigned

Jun 3, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1669096871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3370 SAINT ROSE PKWY APT 411",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 N RANCHO DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303196",
            "telephone_number": "702-800-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JEREMY",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@graduatehouse.org",
            "affiliation": "N",
            "address_1": "3606 N Rancho Dr Ste 102",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891303196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deja Vaughn
• Delores Vaughn
• Gary Vaughn
• Jahnne Vaughn
• James Vaughn III
• Jordan Vaughn
• Keymonni A Vaughn
• Kristalyn Vaughn
• Lenna Joyce Vaughn
• Lillie Vaughn

• Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.