VAUGHN D JACKSON, PLLC
NPI 1710308952
Clinic/Center - Medical Specialty in La Jara, CO

NPI Status: Active since December 13, 2013

Contact Information

412 MAIN
LA JARA, CO
ZIP 81140
Phone: (719) 274-4500
Fax: (719) 274-4504

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  • Organization
  • Clinic/Center
  • Medical Specialty
  • CLIA Number: 06D2079919
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-25-2026

About VAUGHN D JACKSON, PLLC

This page provides the complete NPI Profile along with additional information for Vaughn D Jackson, Pllc, a provider established in La Jara, Colorado operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1710308952 assigned on December 2013. The practitioner's primary taxonomy code is 261QM2500X with license number 31351 (CO). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dr. Vaughn D Jackson M.d. (Sole Member)

NPI
1710308952
Provider Name
VAUGHN D JACKSON, PLLC
Entity Type
Organization
Location Address
412 MAIN LA JARA, CO 81140
Location Phone
(719) 274-4500
Location Fax
(719) 274-4504
Mailing Address
P.O. BOX 272 416 MAIN LA JARA, CO 81140
Mailing Phone
(719) 274-4500
Mailing Fax
(719) 274-4504
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-13-2013
Last Update Date
12-13-2013
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Medical Specialty

Taxonomy Code
261QM2500X
Type
Ambulatory Health Care Facilities
License No.
31351
License State
CO
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. VAUGHN D JACKSON M.D.

Authorized Official Title
SOLE MEMBER
Authorized Official Phone
(719) 274-4500

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
06D2079919
Facility Type
Physician Office
Certificate Effective Date
June 26, 2024
Certificate Expiration Date
June 25, 2026
Laboratory Director
DR. VAUGHN D. JACKSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Vaughn D Jackson, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1710308952, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
1
Doubled → 2
Pos 4
0
Unchanged
Pos 5
3
Doubled → 6
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
9
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 3 → 6 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 2 + 0 + 6 + 0 + 1 + 6 + 9 + 1 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1710308952.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710308952, enumerated as an "organization" on December 13, 2013.

The provider is located at 412 MAIN LA JARA, CO 81140 and the phone number is (719) 274-4500.

Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.