Individual provider Active NPI

Elissa Vaughn, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1033539481
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71015566A Issued in IN
Practice address
1036 Sharon Dr
Jeffersonville, IN 47130-4522
Phone
(812) 280-6606
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71015566A IN Primary

Addresses

Primary practice location

1036 Sharon Dr
Jeffersonville, IN 47130-4522

Mailing address

3515 Middle Rd
Jeffersonville, IN 47130-5509
Phone (502) 889-8490

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241107002576 IN Practitioner - Nurse Practitioner 1153855564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespring, IncGroup PAC ID 5294624508, 65 clinicians

Practice addresses (Care Compare)

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 280-2080

Hospital & facility affiliations

  • Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71015566AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring, Inc CurrentSince Aug 19, 2024 Accepting new patients
Lifespring, Inc CurrentSince Aug 19, 2024 Accepting new patients
Lifespring, Inc Past Accepting new patients

Locations

460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583

1036 Sharon Dr
Jeffersonvlle, IN 47130
Phone (812) 258-9281

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1033539481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 MIDDLE RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305509",
            "telephone_number": "502-889-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SHARON DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471304522",
            "telephone_number": "812-280-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "ELISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71015566A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.