Individual provider Active NPI

Lorraine P Vaughan

  • Family Nurse Practitioner
  • Amityville, NY
National Provider Identifier
1265645865
Registry record updated Jan 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346635 Issued in NY
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

Updated by the provider on Jan 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
620739NYMDRegistered Nurse
28VA1051478NYMDSpecialist
F346635NYMDFamily 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.

Verify at the official NPI Registry.