NPIMap

Individual provider Active NPI

Jodie Vaughn, APN

  • Family Nurse Practitioner
  • Gibson City, IL
National Provider Identifier
1073065140
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015012 Issued in IL
Practice address
1120 N Melvin St
Gibson City, IL 60936-1477
Phone
(217) 784-2258
Fax
(217) 874-2321
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015012 IL Primary

Addresses

Primary practice location

1120 N Melvin St
Gibson City, IL 60936-1477

Mailing address

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 379-4864

Other identifiers 1

IdentifierTypeStateIssuer
OTH000OtherILUPIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jodie.vaughn.p5@direct.gapho.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170223001227 IL Practitioner - Nurse Practitioner 5890079651 Reassigns benefits to 5 organizations
Practice locations: Watseka, IL; Momence, IL; Danville, IL; Hoopeston, IL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince Dec 21, 2016 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Mar 1, 2021 Accepting new patients
Applebaum Physiatry PLLC Family CurrentSince Apr 17, 2023 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Dec 21, 2016 Accepting new patients
Radial Health SC CurrentSince Jun 18, 2023 Accepting new patients

Locations

475 Brown Blvd
Ste 103
Bourbonnais, IL 60914
Phone (815) 936-8962

26895 Network Pl
Chicago, IL 60673

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

5061 N Pulaski Rd
Chicago, IL 60630
Phone (773) 478-1186

801 N Logan Ave
Danville, IL 61832
Phone (217) 443-3106

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

2500 W Higgins Rd
Ste 1165
Hoffman Estates, IL 60169
Phone (647) 610-3188

2013 Midwest Rd
Oak Brook, IL 60523
Phone (630) 495-0220

1001 E Pells St
Paxton, IL 60957
Phone (217) 379-4361

227 N Market St
Paxton, IL 60957
Phone (217) 379-4864

300 W Lowell Ave
Pontiac, IL 61764
Phone (815) 842-1181

715 E Raymond Rd
Watseka, IL 60970
Phone (815) 432-2934

128 S East St
Unit 1109
Crown Point, IN 46308

Interoperability endpoints

  • Direct secure messaging: jodie.vaughn.p5@direct.gapho.nextgenshare.com

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1073065140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-379-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-2258",
            "fax_number": "217-874-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JODIE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "OTH000",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jodie.vaughn.p5@direct.gapho.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "227 N Market St",
            "city": "Paxton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609571123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gibson City, IL

Sources for this page

Verify at the official NPI Registry.