Courtney Vaughan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7851 Issued in GA

Practice address

2406 Lighthouse Manor Dr
Gainesville, GA 30501-7401

Phone

(770) 536-4352

Fax

(770) 532-8165

NPI assigned

Jan 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Brooks Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upson Surgical Associates, LLCGroup PAC ID 2062690480, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upson Regional Medical Center Hospital, Thomaston, GA, CCN 110002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Upson Surgical Associates, LLC

  • Surgery Physician
  • Thomaston, GA
  • NPI 1790076974
  Medicare reassignment Care Compare group

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

• Upson County Hospital Inc

  • General Acute Care Hospital
  • Thomaston, GA
  • NPI 1659376630
  Care Compare affiliation

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1376900563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 LIGHTHOUSE MANOR DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017401",
            "telephone_number": "770-536-4352",
            "fax_number": "770-532-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 LIGHTHOUSE MANOR DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017401",
            "telephone_number": "770-536-4352",
            "fax_number": "770-532-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "COURTNEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "BROOKS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Varghese I, AGPCNP
• Kezia Varghese, DDS
• Marissa Varghese
• Merin Varghese, M.D.
• William Matthew Vassy, M.D.
• Emily R. Vaughan, NP-C
• Matthew Lawrence Vaughn, D.M.D.
• Rebecca Leilani Vaughn, PA
• Ryan Michael Vaughn, D.M.D.
• Elise Raquel Vazquez, PA

• Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.