NPIMap

Individual provider Active NPI

Vaughn Collier, LMP

  • Specialist
  • Bremerton, WA
National Provider Identifier
1861638587
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00017529 Issued in WA
Practice address
1007 Scott Ave
Suite B
Bremerton, WA 98310-4874
Phone
(360) 405-0293
NPI assigned
Dec 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00017529 WA Primary

Addresses

Primary practice location

1007 Scott Ave
Suite B
Bremerton, WA 98310-4874

Mailing address

1007 Scott Ave
Suite B
Bremerton, WA 98310-4874
Phone (360) 405-0293

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00017529WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuv, LLC Specialist Past Accepting new patients
Rejuv Massage and Spa Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1861638587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 SCOTT AVE",
            "address_2": "SUITE B",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104874",
            "telephone_number": "360-405-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 SCOTT AVE",
            "address_2": "SUITE B",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104874",
            "telephone_number": "360-405-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "VAUGHN",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-30",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00017529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.