Individual provider Active NPI

Eric R Vaught, D.O.

  • Family Medicine Physician
  • Middletown, CT
National Provider Identifier
1699939454
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
79767 Issued in CT
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

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200909001639 MA Practitioner - Family Practice 3476971383
I20241209000194 CT Practitioner - Family Practice 3476971383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Dec 3, 2024 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.