Active NPI
Olivia Vaughan, RBT
- Behavior Technician
- Chesapeake, VA
National Provider Identifier
1255934618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-145096
- Practice address
- 1108 Eden Way N
Chesapeake, VA 23320-3339 - Phone
- (703) 596-9332
- NPI assigned
- Nov 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-145096 | TX | Primary |
Addresses
Primary practice location
1108 Eden Way N
Chesapeake, VA 23320-3339
Mailing address
2525 Minnesota Ave
Norfolk, VA 23513-4530
Phone (423) 813-0424
Other practice location 1
136 E Concho Ave
San Angelo, TX 76903-5947
Phone (325) 777-2727
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-145096 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1255934618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 MINNESOTA AVE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235134530",
"telephone_number": "423-813-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 EDEN WAY N",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233203339",
"telephone_number": "703-596-9332"
}
],
"practiceLocations": [
{
"address_1": "136 E Concho Ave",
"address_purpose": "LOCATION",
"city": "San Angelo",
"state": "TX",
"postal_code": "769035947",
"country_code": "US",
"telephone_number": "325-777-2727",
"fax_number": "325-777-2737",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHAN",
"first_name": "OLIVIA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-20-145096",
"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 Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.