Daniel Vaughn, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501004499 Issued in MI

Practice address

4100 Lake Dr SE
Suite 305
Grand Rapids, MI 49546-8292

Phone

(616) 285-1377

Fax

(616) 285-1006

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EJDADD

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.

• Michigan Pain Consultants PC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Rapids, MI
  • NPI 1467418574
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1982761490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 COMMERCE AVE SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034124",
            "telephone_number": "616-940-0660",
            "fax_number": "616-940-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 305",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-285-1377",
            "fax_number": "616-285-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "650D113810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky Lavonne Vass-Reinholtz, LMSW
• Ashley Vasser
• Venkatramana R Vattipally IV, M.D.
• Jamie Lynn Vaughan, PA
• Oneszanetta-Desiree Nina Vaughan
• Derrick Lee Vaughn
• Grace Kathryn Vaughn, PA-C
• Joanna Vaughn, PSY.D.
• Jorrene Melba Vaughn, L.M.S.W.
• Madeline Rose Vaughn, PA-C

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.