Active NPI
Lynn A Vaughan, MD
- Dermatology Physician
- Leavenworth, KS
National Provider Identifier
1316089519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 27598
- Practice address
- 920 6TH Ave
Leavenworth, KS 66048-3225 - Phone
- (913) 682-8900
- NPI assigned
- Feb 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 27598 | KS | Primary |
Addresses
Primary practice location
920 6TH Ave
Leavenworth, KS 66048-3225
Mailing address
989 Pebble Beach Dr
Lansing, KS 66043-1232
Phone (913) 727-2874
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4027819 | Other | KS | AETNA PROVIDER # |
| 0300427 | Other | KS | UNITED HEALTHCARE |
| 27598 | Other | KS | STATE LICENSE |
| 30809019 | Other | KS | BCBS OF KANSAS CITY |
| 102093 | Other | KS | BLUE CROSS BLUE SHIELD KS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27598 | KS | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316089519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "989 PEBBLE BEACH DR",
"city": "LANSING",
"state": "KS",
"postal_code": "660431232",
"telephone_number": "913-727-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 6TH AVE",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660483225",
"telephone_number": "913-682-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "LYNN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "KS",
"license": "27598",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "4027819",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0300427",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "27598",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KANSAS CITY",
"identifier": "30809019",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD KS",
"identifier": "102093",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.