Individual provider Active NPI

Lacia Vaughn, RN

  • Medical-Surgical Registered Nurse
  • Roosevelt, NY
National Provider Identifier
1144185992
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
2311082 Issued in NY
Practice address
14 Branch PL
Roosevelt, NY 11575-1505
Phone
(917) 561-6552
NPI assigned
Dec 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 2311082 NY Primary

Addresses

Primary practice location

14 Branch PL
Roosevelt, NY 11575-1505

Mailing address

14 Branch PL
Roosevelt, NY 11575-1505

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2311082NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1144185992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BRANCH PL",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BRANCH PL",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751505",
            "telephone_number": "917-561-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "LACIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "2311082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.