{"npi":"1225284367","type":"NPI-1","status":"active","name":{"display":"Rolandine Vaughan Pac","other":[],"first":"ROLANDINE","last":"VAUGHAN","credential":"PAC"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"174400000X","description":"Specialist","primary":false,"state":"GA","license":"005982"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"VA","license":"0110002860"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"GA","license":"005982"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":null,"license":null},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"IN","license":"10004230A"}]},"addresses":[{"purpose":"LOCATION","street_1":"1862 AUBURN RD STE 118-X1","city":"DACULA","state":"GA","postal_code":"300191676","country_code":"US","phone":"4049066985","fax":"6783027377"},{"purpose":"MAILING","street_1":"2084 MITFORD CT","city":"DACULA","state":"GA","postal_code":"300192486","country_code":"US","phone":"6789608953","fax":"6783027377"}],"license":{"state":"IN","number":"10004230A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00429217D","state":"GA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20110119001330","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"GA","pac_id":"0143396333"},{"enrlmt_id":"I20131001000280","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"GA","pac_id":"0143396333"},{"enrlmt_id":"I20230217002022","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NY","pac_id":"0143396333"},{"enrlmt_id":"I20230410000884","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"FL","pac_id":"0143396333"},{"enrlmt_id":"I20230717002156","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"OH","pac_id":"0143396333"},{"enrlmt_id":"I20230929002635","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"MN","pac_id":"0143396333"},{"enrlmt_id":"I20231003002002","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"CA","pac_id":"0143396333"},{"enrlmt_id":"I20231016003560","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"MI","pac_id":"0143396333"},{"enrlmt_id":"I20231020002326","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"IL","pac_id":"0143396333"},{"enrlmt_id":"I20240129002818","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"IN","pac_id":"0143396333"}]},"enumeration_date":"2008-08-08","last_updated":"2024-03-15","_meta":{"source":"NPPES","snapshot_date":"2024-03-15","doc_url":"https://findmynpi.com/api"}}