Individual provider Active NPI

Samuel Frederick Vaught, AUD

  • Audiologist
  • Snellville, GA
National Provider Identifier
1992706154
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3479 Issued in GA
Practice address
2176 Oak Rd Ste D
Snellville, GA 30078-2374
Phone
(770) 972-4327
Fax
(770) 927-4101
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3479 GA Primary

Addresses

Primary practice location

2176 Oak Rd Ste D
Snellville, GA 30078-2374

Mailing address

2176 Oak Rd Ste D
Snellville, GA 30078-2374
Phone (770) 972-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060630000187 GA Practitioner - Qualified Audiologist 3971515289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology Center of Snellville LLCGroup PAC ID 1052550407, 2 clinicians

Practice addresses (Care Compare)

2176 Oak Rd
Suite C
Snellville, GA 30078-2374

2176 Oak Road C
Snellbville, GA 30078-2374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3479GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Center of Snellville LLC Audiologist CurrentSince Apr 8, 2013 Accepting new patients
American Hearing Centers Audiologist Past Accepting new patients
Gravante Chiropractic & Nutrition Inc. PastSince Jul 28, 2024 Accepting new patients

Locations

2176 Oak Rd
Ste C
Snellville, GA 30078
Phone (770) 972-4327

2176 Oak Rd
Ste D
Snellville, GA 30078
Phone (678) 990-9400

Organizations & group practices 3

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1992706154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 OAK RD STE D",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782374",
            "telephone_number": "770-972-4327",
            "fax_number": "770-972-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 OAK RD STE D",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782374",
            "telephone_number": "770-972-4327",
            "fax_number": "770-927-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHT",
        "first_name": "SAMUEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "3479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.