Individual provider Active NPI

Regina Vaughn

  • Optician
  • Corbin, KY
National Provider Identifier
1174253397
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
245962 Issued in KY
Practice address
60 S Stewart Rd
Corbin, KY 40701-4675
Phone
(606) 523-5855
Fax
(606) 523-5596
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 245962 KY Primary

Addresses

Primary practice location

60 S Stewart Rd
Corbin, KY 40701-4675

Mailing address

60 S Stewart Rd
Corbin, KY 40701-4675
Phone (606) 523-5855

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

LicenseStateTypeSpecialty
245962KYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1174253397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 S STEWART RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014675",
            "telephone_number": "606-523-5855",
            "fax_number": "606-523-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S STEWART RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014675",
            "telephone_number": "606-523-5855",
            "fax_number": "606-523-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "245962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.