Individual provider Active NPI

Mary Lee Vaughn, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1073971131
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-75562-FNP-BC Issued in WV
Practice address
3075 US Route 60 Ste A110
Huntington, WV 25705-8859
Phone
(304) 528-4600
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 75562 WV
Family Nurse Practitioner 363LF0000X APRN-75562-FNP-BC WV Primary

Addresses

Primary practice location

3075 US Route 60 Ste A110
Huntington, WV 25705-8859

Mailing address

3075 US Route 60
Huntington, WV 25705-8859
Phone (304) 528-4600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MaryVaughn@himg.directbygreenway.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20160308000308 WV Practitioner - Nurse Practitioner 0143526707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Mary'S Himg, LLCGroup PAC ID 8729406459, 80 clinicians

Practice addresses (Care Compare)

147 Willow Tree Way
Hurricane, WV 25526-1085
Phone (304) 697-6000

3075 US Route 60
Huntington, WV 25705-8859
Phone (304) 528-4600

Hospital & facility affiliations

  • St Mary'S Home Health Service Home health agency, Huntington, WV, CCN 517055
  • Centerwell Home Health Home health agency, Ona, WV, CCN 517126
  • St Marys Medical Center Hospital, Huntington, WV, CCN 510007
  • Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-75562-FNP-BCWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Himg, LLC CurrentSince Sep 1, 2020 Accepting new patients
St Marys Medical Center, Inc. PastSince Apr 27, 2025 Accepting new patients
Ultimate Health Services, Inc. Past Accepting new patients

Locations

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

3075 US Route 60
Ste A110
Huntington, WV 25705
Phone (304) 526-1234

147 Willow Tree Way
Hurricane, WV 25526
Phone (304) 397-3002

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61599
  • Direct secure messaging: maryvaughn@himg.directbygreenway.com

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 4

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": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1073971131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058859",
            "telephone_number": "304-528-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 US ROUTE 60 STE A110",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058859",
            "telephone_number": "304-528-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "MARY",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "75562",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN-75562-FNP-BC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MaryVaughn@himg.directbygreenway.com",
            "affiliation": "N",
            "address_1": "5170 US RT 60 East",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.