Individual provider Active NPI

Katherine Marie Vaughn, CNM

  • Advanced Practice Midwife
  • Johns Creek, GA
National Provider Identifier
1255083697
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN-CNM297847 Issued in GA
Practice address
10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497
Phone
(404) 446-2496
NPI assigned
Jan 26, 2022
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN-CNM297847 GA Primary

Addresses

Primary practice location

10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497

Mailing address

780 Memorial Dr SE Apt 509
Atlanta, GA 30316-1599
Phone (404) 446-2496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501000986 GA Practitioner - Certified Nurse Midwife (CNM) 1153899752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1611

Northside Hospital Managed Care Dept
905 1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN-CNM297847GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Obstetrics and Gynecology of North Atlanta PC CurrentSince Dec 16, 2023 Accepting new patients
North Perimeter Anesthesia LLC PastSince Feb 1, 2022 Accepting new patients

Locations

10692 Medlock Bridge Rd
Ste 100A
Johns Creek, GA 30097
Phone (404) 446-2492

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1255083697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 MEMORIAL DR SE APT 509",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161599",
            "telephone_number": "404-446-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10692 MEDLOCK BRIDGE RD STE 100A",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978497",
            "telephone_number": "404-446-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "APRN-CNM297847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.