Active NPI
Shannon McKala Vaughn
- Speech-Language Pathologist
- Jacksonville, AL
National Provider Identifier
1083926166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3068
- Practice address
- 1486 Bailee Way SW
Jacksonville, AL 36265-3318 - Phone
- (256) 490-6980
- NPI assigned
- Jul 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3068 | AL | Primary |
Addresses
Primary practice location
1486 Bailee Way SW
Jacksonville, AL 36265-3318
Mailing address
1486 Bailee Way SW
Jacksonville, AL 36265-3318
Phone (256) 490-6980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3068 | AL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1083926166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1486 BAILEE WAY SW",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "362653318",
"telephone_number": "256-490-6980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1486 BAILEE WAY SW",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "362653318",
"telephone_number": "256-490-6980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "SHANNON",
"middle_name": "MCKALA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "3068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.