Individual provider Active NPI

William Thomas Vaughn, D.C.

  • Chiropractor
  • Mercer, PA
National Provider Identifier
1770607079
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007489L Issued in PA
Practice address
1424 N Perry Hwy
Mercer, PA 16137-4324
Phone
(724) 475-4065
Fax
(724) 475-2250
NPI assigned
Mar 19, 2007
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007489-L PA
Chiropractor 111N00000X DC007489L PA Primary

Addresses

Primary practice location

1424 N Perry Hwy
Mercer, PA 16137-4324

Mailing address

1424 N Perry Hwy
Mercer, PA 16137-4324
Phone (724) 475-4065

Other identifiers 1

IdentifierTypeStateIssuer
565394OtherPABLUE CROSS - IND PROVIDER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000385 PA Practitioner - Chiropractic 1052319357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1424 N Perry Hwy
Mercer, PA 16137-4324
Phone (724) 475-4065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007489-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vaughn Specific Chiropractic P.C. Chiropractor CurrentSince Aug 1, 1999 Accepting new patients

Locations

1424 N Perry Hwy
Mercer, PA 16137
Phone (724) 475-4065

1424 N Perry Hwy
#T
Mercer, PA 16137

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1770607079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 N PERRY HWY",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161374324",
            "telephone_number": "724-475-4065",
            "fax_number": "724-475-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 N PERRY HWY",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161374324",
            "telephone_number": "724-475-4065",
            "fax_number": "724-475-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007489-L",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007489L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - IND PROVIDER",
            "identifier": "565394",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.