Individual provider Active NPI

Jonathan Cole Vaughn, DPT

  • Physical Therapist
  • Fayetteville, AR
National Provider Identifier
1932755766
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4686 Issued in AR
Practice address
2793 E Millennium PL Ste 2
Fayetteville, AR 72703-6522
Phone
(479) 521-2232
Fax
(479) 521-0513
NPI assigned
Aug 16, 2019
Last updated
Aug 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4686 AR Primary

Addresses

Primary practice location

2793 E Millennium PL Ste 2
Fayetteville, AR 72703-6522

Mailing address

1350 S Gutensohn Rd Ste 10
Springdale, AR 72762-5210
Phone (479) 751-7122

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
PT4686ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Rehabilitation Pinnacle Point Physical Therapist PastSince Aug 18, 2019 Accepting new patients
Trinity Rehabilitation Inc Physical Therapist PastSince Aug 18, 2019 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, 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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1932755766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S GUTENSOHN RD STE 10",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625210",
            "telephone_number": "479-751-7122",
            "fax_number": "479-751-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2793 E MILLENNIUM PL STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036522",
            "telephone_number": "479-521-2232",
            "fax_number": "479-521-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JONATHAN",
        "middle_name": "COLE",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.