Active NPI
Joshua Robert Vaughan, DNP, CRNA
- Certified Registered Nurse Anesthetist
- Breese, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209023291
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Center
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
- HSHS St Elizabeth'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041463654 | IL | MD | Registered Nurse |
| 209023291 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | 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.
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
IL
-
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
Hospital
-
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital
-
- General Acute Care Hospital
- Breese, IL
- NPI 1457319154
Hospital
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.