Glen E Vaughn, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35053859 Issued in OH

Practice address

2801 Bay Park Dr
Oregon, OH 43616-4920

Phone

(419) 690-7900

NPI assigned

Aug 19, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1699767293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633390",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452633390",
            "telephone_number": "800-594-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BAY PARK DR",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164920",
            "telephone_number": "419-690-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "GLEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35053859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000246976",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4488340",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000550256",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0634497",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Usman, PA-C
• Abhishek Vaidya
• Alecia Valentine, PTA
• Alexander Vargo Jr., PT
• Derek A Vasko, DDS
• Susan L Vild, MSN, RN, FNP C
• Oswaldo E. Vilela, M.D.
• Virginia Carner Dunn DDS Inc
• Jessica Irene Buzon Vogel, OTR
• Robbin W Wagener, OD

• Emergency Medicine Physician in Oregon, OH
• Providers in Oregon, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.