Active NPI
Denise Michelle Vaughan, REGISTERED NURSE
- Adult Psychiatric/Mental Health Registered Nurse
- Richmond, VA
National Provider Identifier
1104596089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 0001279908
- Practice address
- 4926 W Broad St
Richmond, VA 23230-3122 - Phone
- (804) 673-5241
- Fax
- (804) 977-6244
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 0001279908 | VA | Primary |
Addresses
Primary practice location
4926 W Broad St
Richmond, VA 23230-3122
Mailing address
4920 W Broad St
Richmond, VA 23230-3115
Phone (804) 673-5241
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 |
|---|---|---|---|
| 0001279908 | VA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1104596089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 W BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303115",
"telephone_number": "804-673-5241",
"fax_number": "804-977-6244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4926 W BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303122",
"telephone_number": "804-673-5241",
"fax_number": "804-977-6244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "DENISE",
"middle_name": "MICHELLE",
"credential": "REGISTERED NURSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "VA",
"license": "0001279908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.