Individual provider Active NPI

Genesis Emilia Vaughn, OTD

  • Occupational Therapist
  • Ellicott City, MD
National Provider Identifier
1336986090
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
10298 Issued in MD
Practice address
5086 Dorsey Hall Dr
Ellicott City, MD 21042-7711
Phone
(240) 470-0743
NPI assigned
Jul 10, 2024
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10298 MD Primary

Addresses

Primary practice location

5086 Dorsey Hall Dr
Ellicott City, MD 21042-7711

Mailing address

1003 Flester LN
Laurel, MD 20707-6512
Phone (240) 381-6948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814000723 MD Practitioner - Occupational Therapist in Private Practice 4082152665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

910 Frederick Rd
Catonsville, MD 21228-4516
Phone (410) 644-1880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10298MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Aug 5, 2024 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC Occupational Therapist CurrentSince Aug 5, 2024 Accepting new patients
Capitol Health Care, LLC Occupational Therapist PastSince Jul 1, 2020 Accepting new patients

Locations

910 Frederick Rd
Catonsville, MD 21228

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11237/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1336986090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 FLESTER LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207076512",
            "telephone_number": "240-381-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5086 DORSEY HALL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427711",
            "telephone_number": "240-470-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "GENESIS",
        "middle_name": "EMILIA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "10298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.