Individual provider Active NPI

Barbara Vaughan, D.P.T.

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1700964939
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008166 Issued in GA
Practice address
4779 S Atlanta Rd SE
Suite 300
Atlanta, GA 30339-1520
Phone
(404) 664-9334
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008166 GA Primary
Physical Therapist 225100000X PT008166 GA

Addresses

Primary practice location

4779 S Atlanta Rd SE
Suite 300
Atlanta, GA 30339-1520

Mailing address

1925 Main St SE
Smyrna, GA 30080-6913
Phone (404) 664-9334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000292 GA Practitioner - Physical Therapist in Private Practice 3678539657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fit Core Physical Therapy IncGroup PAC ID 5799094181, 2 clinicians

Practice addresses (Care Compare)

4779 S Atlanta Rd SE
Suite 100
Atlanta, GA 30339-1565
Phone (404) 479-1739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008166GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Set Sports Physical Therapy CurrentSince Jul 29, 2013 Accepting new patients
Set Sports Physical Therapy, LLC Past Accepting new patients
The Sports Rehabilitation Center PastSince Oct 3, 2011 Accepting new patients

Locations

1770 The Exchange SE
Ste 200
Atlanta, GA 30339
Phone (202) 210-1131

Organizations & group practices 4

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1700964939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MAIN ST SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806913",
            "telephone_number": "404-664-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4779 S ATLANTA RD SE",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303391520",
            "telephone_number": "404-664-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "BARBARA",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "008166",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.