Carey Diana Vaughan, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2011022512 Issued in MO

Practice address

1014 Madison St
Jefferson City, MO 65101-3458

Phone

(573) 644-6999

Fax

(573) 644-7880

NPI assigned

Jun 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2017 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Capital Region Medical Center

  • Cardiovascular Disease Physician
  • Jefferson City, MO
  • NPI 1659973857
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1821352857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013458",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013458",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "CAREY",
        "middle_name": "DIANA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2011022512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urology Care, Inc.
• Jennifer Rachelle Vandeloecht, RN
• Cortny Osie-Ann Vandergrift
• Michael A Vangundy, LPC
• Andrea Dawn Vanhooser, RN
• Jane A. Vaughan, FNP
• Thomas E Vaughn, LPC
• Vijay Sai Veerapaneni, MD
• Rebecca Veth, PLPC
• Amy Vieth, P.T.

• General Practice Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.