NPIMap

Organization Active NPI

Vaughan Physician Practices, LLC

  • Surgery Physician
  • Selma, AL
National Provider Identifier
1770928103
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
VAUGHAN PHYSICIAN PRACTICES, LLC
Practice address
1023 Medical Center Pkwy
Suite 311
Selma, AL 36701-6780
Phone
(334) 418-6652
Fax
(334) 418-6965
NPI assigned
Apr 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Vickie Austin
Title
Office Manager
Phone
(334) 418-4113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X AL Primary

Addresses

Primary practice location

1023 Medical Center Pkwy
Suite 311
Selma, AL 36701-6780

Mailing address

1023 Medical Center Pkwy
Suite 311
Selma, AL 36701-6780
Phone (334) 418-6652

Other names 1

  • Vaughan Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070604000705 AL Part B Supplier - Clinic/Group Practice 8123126851 Receives reassigned benefits from 36 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Selma, AL; Marion, AL; Camden, AL

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1770928103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 MEDICAL CENTER PKWY",
            "address_2": "SUITE 311",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016780",
            "telephone_number": "334-418-6652",
            "fax_number": "334-418-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 MEDICAL CENTER PKWY",
            "address_2": "SUITE 311",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016780",
            "telephone_number": "334-418-6652",
            "fax_number": "334-418-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAUGHAN PHYSICIAN PRACTICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-418-4113"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vaughan Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Selma, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.