Amy a Vaughan Dermatology PLLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

18579 Issued in WV

Legal business name

AMY A VAUGHAN DERMATOLOGY PLLC

Practice address

6007 US RT 60 East
Suite 130
Barboursville, WV 25504

Phone

(304) 733-3333

Fax

(304) 733-3666

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Amy A Vaughan, MDNPI 1073503223

Title

Physician President

Phone

(304) 733-3333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy A Vaughan II, MD

  • Dermatology Physician
  • Barboursville, WV
  • NPI 1073503223
  Medicare reassignment Care Compare group NPD Authorized official
• Meagan Watts Shepherd, M.D.

  • Allergy & Immunology Physician
  • Barboursville, WV
  • NPI 1184815003
  Medicare reassignment Care Compare group NPD
• Megan Sierra Slack, FNP-BC

  • Family Nurse Practitioner
  • Barboursville, WV
  • NPI 1992285902
  Medicare reassignment Care Compare group NPD
• Tommy D Dooley II, PA-C

  • Physician Assistant
  • Barboursville, WV
  • NPI 1740709138
  Medicare reassignment Care Compare group
• Ashley R Grimmett, PAC

  • Physician Assistant
  • Scott Depot, WV
  • NPI 1417047242
  Medicare reassignment
• Tara J. Robinson, PA-C

  • Medical Physician Assistant
  • Charleston, WV
  • NPI 1508167867
  Medicare reassignment

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154411908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 937",
            "address_2": "6007 US RT 60 E SUITE 130",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "25504",
            "telephone_number": "304-733-3333",
            "fax_number": "304-733-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 US RT 60 EAST",
            "address_2": "SUITE 130",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "25504",
            "telephone_number": "304-733-3333",
            "fax_number": "304-733-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY A VAUGHAN DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "304-733-3333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WV",
            "license": "18579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi America
• Monica America
• Shania Ammons
• Kaylee Amos
• Madison Amos
• Cierra Anders
• Alisha Anderson
• Cathy Anderson
• Courtney Anderson
• Dominique Brooke Anderson

• Procedural Dermatology Physician in Barboursville, WV
• Providers in Barboursville, WV by specialty
• Procedural Dermatology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.