Active NPI
Lorraine P Vaughan
- Family Nurse Practitioner
- Amityville, NY
National Provider Identifier
1265645865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F346635
- Practice address
- 15 Harrison Ave Apt 23C
Amityville, NY 11701-2431 - Phone
- (631) 789-6552
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 620739 | NY | |
| Specialist | 174400000X | 28VA1051478 | NY | |
| Family Nurse Practitioner | 363LF0000X | F346635 | NY | Primary |
Addresses
Primary practice location
15 Harrison Ave Apt 23C
Amityville, NY 11701-2431
Mailing address
15 Harrison Ave Apt 23C
Amityville, NY 11701-2431
Phone (631) 789-6552
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 |
|---|---|---|---|
| 620739 | NY | MD | Registered Nurse |
| 28VA1051478 | NY | MD | Specialist |
| F346635 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609632000000",
"number": "1265645865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 HARRISON AVE APT 23C",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012431",
"telephone_number": "631-789-6552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 HARRISON AVE APT 23C",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012431",
"telephone_number": "631-789-6552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "LORRAINE",
"middle_name": "P",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2021-01-03",
"certification_date": "2021-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "620739",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "28VA1051478",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F346635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.