DR. JACOB WALKER VAUGHT DO NPI 1124607031

NPI Information

NPI: 1124607031
Provider Name: DR. JACOB WALKER VAUGHT, DO
Classification: Pediatrics - 208000000X
Entity Type: Individual
PECOS Registration: Yes
Address: 2750 DANTZLER DR UNIT 102
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 876-1818

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NPI Details

DR. Jacob Walker Vaught, DO is a pediatrics in North Charleston, SC with 5 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Jacob Walker Vaught, DO NPI is 1124607031. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EDWARD VIA COL OF OSTEO MEDICINE-CAROLINAS CAMPUS
Graduation Year:2021

The provider's business location address is:

2750 DANTZLER DR UNIT 102
NORTH CHARLESTON, SC
ZIP 29406-006
Phone: (843) 876-1818

The NPI 1124607031 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/7/2021 and was last updated on 11/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208M00000X	Hospitalist	94543	SOUTH CAROLINA	No
2	208000000X	Pediatrics	94543	SOUTH CAROLINA	Yes
3	390200000X	Student in an Organized Health Care Education/Training Program			No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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