Individual provider Active NPI

Richard Marlon Vaughn, M.D.

  • Pediatrics Physician
  • Tullahoma, TN
National Provider Identifier
1164418190
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD034005 Issued in TN
Practice address
710 Kings LN
Tullahoma, TN 37388-5395
Phone
(931) 455-7044
Fax
(931) 455-7043
NPI assigned
Sep 26, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD034005 TN Primary

Addresses

Primary practice location

710 Kings LN
Tullahoma, TN 37388-5395

Mailing address

710 Kings LN
Tullahoma, TN 37388-5395
Phone (931) 455-7044

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD034005TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pediatric Center of Tullahoma, PC Pediatrics Past Accepting new patients
Privia Medical Group Tennessee LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25094/brand/1/csg/1/fhir/r4
  • Direct secure messaging: richard.vaughn.1@25094.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164418190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 KINGS LN",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373885395",
            "telephone_number": "931-455-7044",
            "fax_number": "931-455-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KINGS LN",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373885395",
            "telephone_number": "931-455-7044",
            "fax_number": "931-455-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "RICHARD",
        "middle_name": "MARLON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD034005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.