Individual provider Active NPI

William E Vaughan Jr., D.O.

  • Family Medicine Physician
  • Lansdale, PA
National Provider Identifier
1972641926
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS016142 Issued in PA
Practice address
2026 N Broad St
Lansdale, PA 19446-1004
Phone
(215) 368-4344
Fax
(215) 361-7579
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51937 SC
Family Medicine Physician 207Q00000X 2018-01137 NC
Family Medicine Physician 207Q00000X 02005386A IN
Family Medicine Physician 207Q00000X R8507 TX
Family Medicine Physician 207Q00000X DO034759 DC
Family Medicine Physician 207Q00000X 0102201899 VA
General Practice Physician 208D00000X 0102201899 VA
Family Medicine Physician 207Q00000X OS016142 PA Primary

Addresses

Primary practice location

2026 N Broad St
Lansdale, PA 19446-1004

Mailing address

2500 Maryland Rd
Suite #400
Willow Grove, PA 19090-1216
Phone (215) 481-3064

Other identifiers 1

IdentifierTypeStateIssuer
102915668MedicaidPA

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
02005386AINMDFamily Medicine Physician
2018-01137NCMDFamily Medicine Physician
0102201899VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1972641926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARYLAND RD",
            "address_2": "SUITE #400",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901216",
            "telephone_number": "215-481-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 N BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461004",
            "telephone_number": "215-368-4344",
            "fax_number": "215-361-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "51937",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-01137",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005386A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8507",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "DO034759",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201899",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102201899",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102915668",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.