Individual provider Active NPI

Joshua Robert Vaughan, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Breese, IL
National Provider Identifier
1306430699
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209023291 Issued in IL
Practice address
9515 Holy Cross LN
Breese, IL 62230-3618
Phone
(618) 526-8050
NPI assigned
Feb 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041463654 IL
Certified Registered Nurse Anesthetist 367500000X 209023291 IL Primary

Addresses

Primary practice location

9515 Holy Cross LN
Breese, IL 62230-3618

Mailing address

9515 Holy Cross LN
Breese, IL 62230-3618

Other practice location 1

650 W Taylor St
Vandalia, IL 62471-1227
Phone (618) 283-5451

Other practice location 2

1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 258-4329

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvaughan306331@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001491 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648679118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, shared by 11 NPIs, 411 clinicians
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525

9515 Holy Cross LN
Breese, IL 62230-3618
Phone (618) 526-4511

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Breese, IL, CCN 140145
  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041463654ILMDRegistered Nurse
209023291ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Jul 14, 2025 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jan 3, 2026 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince May 15, 2022 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jul 14, 2025 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1306430699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 HOLY CROSS LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 HOLY CROSS LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303618",
            "telephone_number": "618-526-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "IL",
            "postal_code": "624711227",
            "country_code": "US",
            "telephone_number": "618-283-5451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-258-4329",
            "fax_number": "217-258-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "JOSHUA",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-26",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041463654",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209023291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvaughan306331@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9515 Holy Cross Ln",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.