Individual provider Active NPI

Dora E Vaughn, MT

  • Massage Therapist
  • Placerville, CA
National Provider Identifier
1700135209
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
31167 Issued in CA
Practice address
4535 Missouri Flat Rd
2F
Placerville, CA 95667-6846
Phone
(530) 306-5834
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 31167 CA Primary

Addresses

Primary practice location

4535 Missouri Flat Rd
2F
Placerville, CA 95667-6846

Mailing address

2501 Countryside Dr
Placerville, CA 95667-7701
Phone (530) 306-5834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1700135209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 COUNTRYSIDE DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956677701",
            "telephone_number": "530-306-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 MISSOURI FLAT RD",
            "address_2": "2F",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676846",
            "telephone_number": "530-306-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "DORA",
        "middle_name": "E",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "31167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.