Individual provider Active NPI

Kellie Vaughn, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1245705698
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-139342 Issued in AL
Practice address
2205 Cahaba Valley Dr
Birmingham, AL 35242-2602
Phone
(205) 968-1227
Fax
(334) 218-5815
NPI assigned
Oct 11, 2018
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-139342 AL Primary

Addresses

Primary practice location

2205 Cahaba Valley Dr
Birmingham, AL 35242-2602

Mailing address

2205 Cahaba Valley Dr
Birmingham, AL 35242-2602
Phone (205) 968-1228

Other practice location 1

535 Jack Warner Pkwy NE Ste G1
Tuscaloosa, AL 35404-5715
Phone (205) 553-9171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124000049 AL Practitioner - Nurse Practitioner 3173860533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amh Enterprises LLCGroup PAC ID 1153651666, 21 clinicians

Practice addresses (Care Compare)

2205 Cahaba Valley Dr
Birmingham, AL 35242-2602
Phone (205) 968-1227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-139342ALMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amh Enterprises LLC CurrentSince Jan 1, 2025 Accepting new patients
North Shelby Psychiatric Services, Inc. CurrentSince Dec 8, 2018 Accepting new patients
Jackson Center Psychiatric/Mental Health CurrentSince Aug 25, 2024 Accepting new patients

Locations

785 N Dean Rd
Ste 400
Auburn, AL 36830
Phone (334) 275-7440

198 Narrows Dr
Ste 105
Birmingham, AL 35242
Phone (205) 407-4150

1109 Townhouse Rd
Helena, AL 35080
Phone (205) 267-2945

2032 Valleydale Rd
Ste D
Hoover, AL 35244
Phone (205) 621-8677

2205 Cahaba Valley Dr
Hoover, AL 35242
Phone (205) 968-1227

233 Winton M Blount Loop
Montgomery, AL 36117
Phone (334) 207-3188

1940 Highway 33
Unit A
Pelham, AL 35124
Phone (205) 664-1040

535 Jack Warner Pkwy NE
Ste G1
Tuscaloosa, AL 35404
Phone (205) 462-0696

Organizations & group practices 3

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1245705698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CAHABA VALLEY DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422602",
            "telephone_number": "205-968-1228",
            "fax_number": "334-218-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 CAHABA VALLEY DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422602",
            "telephone_number": "205-968-1227",
            "fax_number": "334-218-5815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Jack Warner Pkwy NE Ste G1",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354045715",
            "country_code": "US",
            "telephone_number": "205-553-9171",
            "fax_number": "334-218-5815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KELLIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-139342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.