Active NPI
Judith B. Vaughan, MD
- Neurology Physician
- Elk Grove, CA
National Provider Identifier
1821176561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- G86938
- Practice address
- 6440 Laguna Mirage LN
Elk Grove, CA 95758-5463 - Phone
- (916) 284-1275
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | G86938 | CA | Primary |
Addresses
Primary practice location
6440 Laguna Mirage LN
Elk Grove, CA 95758-5463
Mailing address
6440 Laguna Mirage LN
Elk Grove, CA 95758-5463
Phone (916) 284-1275
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G869380 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G86938 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821176561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6440 LAGUNA MIRAGE LN",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957585463",
"telephone_number": "916-284-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6440 LAGUNA MIRAGE LN",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957585463",
"telephone_number": "916-284-1275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "JUDITH",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "G86938",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G869380",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.