Vaughn D Jackson, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

31351 Issued in CO

Legal business name

VAUGHN D JACKSON, PLLC

Practice address

412 Main
La Jara, CO 81140

Phone

(719) 274-4500

Fax

(719) 274-4504

NPI assigned

Dec 13, 2013

Last updated

Dec 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Vaughn D Jackson, M.D.

Title

Sole Member

Phone

(719) 274-4500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1710308952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 272",
            "address_2": "416 MAIN",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-4500",
            "fax_number": "719-274-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MAIN",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-4500",
            "fax_number": "719-274-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAUGHN D JACKSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VAUGHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "719-274-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CO",
            "license": "31351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph T. Valdez, R.PH
• Valentine Center for Family Therapy
• Valentine Counseling Center PLLC
• Tamera Ann Valentine, MA, LMFTC
• Valley-Wide Health Systems, Inc (La Jara Dental Clinic)
• Lauren Alyse Warner, DO

• Medical Specialty Clinic/Center in La Jara, CO
• Providers in La Jara, CO by specialty
• Medical Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.