Vaughn William Kelly, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

238192 Issued in AK

Practice address

2500 S Woodworth Loop
Palmer, AK 99645-8984

Phone

(907) 861-6000

NPI assigned

Jun 5, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mat-Su Valley III LLCGroup PAC ID 5496941502, 26 clinicians

Mat Su Valley Medical Center LLCGroup PAC ID 5698686475, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vaughn.kelly.1@2839.direct.athenahealth.com

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.

• Mat Su Valley Medical Center LLC

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1912950148
  Medicare reassignment Care Compare group NPD
• Mat-Su Valley III LLC

  • Internal Medicine Physician
  • Palmer, AK
  • NPI 1366752560

  Family

  Medicare reassignment Care Compare group NPD
• Mat-Su Valley III LLC

  • Urgent Care Clinic/Center
  • Palmer, AK
  • NPI 1518472984
  NPD
• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  NPD
• Mat Su Valley Medical Center LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Palmer, AK
  • NPI 1003838384
  NPD (past)
• Mat-Su Valley III LLC

  • Urgent Care Clinic/Center
  • Palmer, AK
  • NPI 1861935975
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1013801877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "907-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "907-861-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "VAUGHN",
        "middle_name": "WILLIAM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "238192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Gatica Physical Therapy, LLC
• Laken Keller
• Carla Beth Kelly
• Marisa Mae Kelly, RN
• Owen Kelly
• Heidi Jo Kemble, LMT
• Alice Raven Kenneally, PA-C
• Mary E. Kenshalo
• Colleen Kersgard, MD
• William Kerst, PH.D.

• Family Nurse Practitioner in Palmer, AK
• Providers in Palmer, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.