Individual provider Active NPI

Kim Cherry-Vaughn

  • Registered Nurse
  • Chesapeake, VA
National Provider Identifier
1194199448
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001223130 Issued in VA
Practice address
2709 Campostella Rd
Suites I and J
Chesapeake, VA 23324-3604
Phone
(757) 289-5810
NPI assigned
Nov 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001223130 VA Primary

Addresses

Primary practice location

2709 Campostella Rd
Suites I and J
Chesapeake, VA 23324-3604

Mailing address

PO Box 13354
Chesapeake, VA 23325-0354
Phone (757) 289-5810

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
0001223130VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1194199448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13354",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233250354",
            "telephone_number": "757-289-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 CAMPOSTELLA RD",
            "address_2": "SUITES I AND J",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233243604",
            "telephone_number": "757-289-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY-VAUGHN",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001223130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.