Individual provider Active NPI

Victoria Reynolds-Vaughn, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1386105294
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7032 Issued in OK
Practice address
744 W 9TH St
Tulsa, OK 74127-9020
Phone
(918) 599-1000
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OK
Emergency Medicine Physician 207P00000X 7032 OK Primary

Addresses

Primary practice location

744 W 9TH St
Tulsa, OK 74127-9020

Mailing address

11850 S 4260 Rd
Chelsea, OK 74016-5557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200902001884 OK Practitioner - Emergency Medicine 3678990850 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Adair County Health Center,Inc. Current Accepting new patients
Adair County Health Center, Inc. CurrentSince Jun 13, 2022 Accepting new patients
Adair County Health Center, Inc. CurrentSince Jun 13, 2022 Accepting new patients

Locations

1401 W Locust St
Stilwell, OK 74960
Phone (918) 696-3101

Interoperability endpoints

  • Direct secure messaging: vreynoldsvaughn213566@direct.integrisok.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1386105294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 S 4260 RD",
            "city": "CHELSEA",
            "state": "OK",
            "postal_code": "740165557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS-VAUGHN",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.