Individual provider Active NPI

Michael Henry Vaughan, M.D.

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1104182641
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23848 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 772-2980
Fax
(662) 772-2960
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-13941 AR
Internal Medicine Physician 207R00000X 52692 TN
Internal Medicine Physician 207R00000X 23848 MS Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Other practice location 1

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-3610

Other practice location 2

2100 N 7th St
West Memphis, AR 72301-2017
Phone (901) 226-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, AR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150731015753 TN Practitioner - Internal MedicinePractitioner - Emergency MedicinePractitioner - Pediatric Medicine 8123264983 Reassigns benefits to 1 organization
I20160330000693 MS Practitioner - Internal Medicine 8123264983 Reassigns benefits to 1 organization
I20210301002870 AR Practitioner - Internal Medicine 8123264983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

2013 Exeter Rd
Germantown, TN 38138-3946
Phone (901) 737-4035

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2130

7715 Wolf River Blvd
Germantown, TN 38138-1706
Phone (901) 328-6031

8138 Country Village Dr
Cordova, TN 38016-2029
Phone (901) 725-8606

Hospital & facility affiliations

  • Baptist Trinity Homecare & Hospice Home health agency, Cordova, TN, CCN 447407
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-13941ARMDInternal Medicine Physician
23848MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Cherokee Health Systems Internal Medicine Current Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Mar 1, 2016 Accepting new patients
Baptist Memorial Hospital-Desoto, Inc, Past Accepting new patients

Locations

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

Organizations & group practices 4

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 7

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1104182641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202113",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 N 7th St",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723012017",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-13941",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52692",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.