Individual provider Active NPI

Cynthia Angella Vaughan, NP

  • Family Nurse Practitioner
  • Snellville, GA
National Provider Identifier
1124770136
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN158896 Issued in GA
Practice address
4296 Round Stone Dr
Snellville, GA 30039-8732
Phone
(678) 598-1144
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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 RN158896 GA Primary

Addresses

Primary practice location

4296 Round Stone Dr
Snellville, GA 30039-8732

Mailing address

4296 Round Stone Dr
Snellville, GA 30039-8732
Phone (678) 598-1144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000330 GA Practitioner - Nurse Practitioner 7214453885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN158896GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True Care Physicians LLC CurrentSince Feb 21, 2025 Accepting new patients

Locations

11175 Cicero Dr
Ste 100
Alpharetta, GA 30022
Phone (214) 783-6295

1324 Rockbridge Rd
Stone Mtn, GA 30087
Phone (678) 390-5096

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1124770136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4296 ROUND STONE DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398732",
            "telephone_number": "678-598-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4296 ROUND STONE DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398732",
            "telephone_number": "678-598-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "CYNTHIA",
        "middle_name": "ANGELLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN158896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.