Active NPI
Eric R Vaught, D.O.
- Family Medicine Physician
- Middletown, CT
National Provider Identifier
1699939454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 79767
- Practice address
- 675 Main St
Middletown, CT 06457-2732 - Phone
- (860) 347-6971
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 282170 | MA | |
| Family Medicine Physician | 207Q00000X | 79767 | CT | Primary |
Addresses
Primary practice location
675 Main St
Middletown, CT 06457-2732
Mailing address
19 Grand St
Middletown, CT 06457-2705
Phone (860) 347-6971
Other practice location 1
387 Quarry St Ste 100
Fall River, MA 02723-1026
Phone (508) 679-8111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center Inc | Current | Accepting new patients | |
| Community Health Center Inc | Family Medicine | Current | Accepting new patients |
| Community Health Center Inc. | Family Medicine | Past | Accepting new patients |
Locations
19 Grand St
Middletown, CT 06457
Phone (860) 323-0172
Interoperability endpoints
- eric.vaught@chcict.eclinicaldirectplus.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Middletown, CT
- NPI 1952591851
Family Medicine
-
dba City of Danbury Emergency Shelter WYA
- Federally Qualified Health Center (FQHC)
- Danbury, CT
- NPI 1003332446
-
- Federally Qualified Health Center (FQHC)
- Middletown, CT
- NPI 1164463840
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1699939454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 GRAND ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572705",
"telephone_number": "860-347-6971",
"fax_number": "860-638-6831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 MAIN ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572732",
"telephone_number": "860-347-6971"
}
],
"practiceLocations": [
{
"address_1": "387 Quarry St Ste 100",
"address_purpose": "LOCATION",
"city": "Fall River",
"state": "MA",
"postal_code": "027231026",
"country_code": "US",
"telephone_number": "508-679-8111",
"fax_number": "508-679-8116",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHT",
"first_name": "ERIC",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-10",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "282170",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "79767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.