Polly S Vaughan, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.09551 Issued in OH

Practice address

140 Fairway Dr
Wilmington, OH 45177-8008

Phone

(937) 974-5591

Fax

(937) 730-0023

NPI assigned

Oct 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: polly.vaughan.1@27093.direct.athenahealth.com
• FHIR API: https://api.qualifacts.org/api/fhir/fsadayton/r4/

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.

• Fairway Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, OH
  • NPI 1780328344
  Medicare reassignment NPD Authorized official
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment Care Compare group NPD
• Family Service Association

  • Adult Mental Health Clinic/Center
  • Moraine, OH
  • NPI 1063442390
  Medicare reassignment NPD
• Talbert House Primary Care

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1225492747
  NPD (past)

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

• Kettering Medical Center

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778976000000",
    "number": "1063609287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 GURNEYVILLE RD",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451776508",
            "telephone_number": "937-313-4400",
            "fax_number": "937-488-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FAIRWAY DR",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451778008",
            "telephone_number": "937-974-5591",
            "fax_number": "937-730-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "POLLY",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2026-05-17",
        "certification_date": "2026-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.09551",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.09551",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "NP-09551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pvaughan552279@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave # 2W",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave # 2W",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• University Family Physicians, Inc.
• Elizabeth Valentine
• Marisa Valentine, CNP
• David Todd Vanzant, DDS
• Ethan Varner, MD
• Kelli Lynn Veidt
• Gabrielle Nicole Veldman, DPT, PT
• Venture Health, LLC
• Leanna S Vestal, CDCA
• Brittany Renee Vinup, CNA

• Psychiatric/Mental Health Nurse Practitioner in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2026; 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.