Individual provider Active NPI

Cassie Renee Vaughn, PA-C

  • Physician Assistant
  • Barbourville, KY
National Provider Identifier
1386274850
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2614 Issued in KY
Practice address
215 N Allison Ave
Barbourville, KY 40906-1336
Phone
(606) 546-9287
NPI assigned
Jan 23, 2020
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2614 KY Primary

Addresses

Primary practice location

215 N Allison Ave
Barbourville, KY 40906-1336

Mailing address

PO Box 1150
Barbourville, KY 40906-5150
Phone (606) 627-4002

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200312001314 KY Practitioner - Physician Assistant 9537597299 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8426
Phone (954) 939-5000

215 N Allison Ave
Barbourville, KY 40906-1336
Phone (606) 546-9287

PO Box
Suite 1150
Barbourville, KY 40906-1336

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2614KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barbourville Family Health Center Family Medicine CurrentSince Jan 21, 2020 Accepting new patients
Barbourville Family Health Center Family Medicine Past Accepting new patients

Locations

215 N Allison Ave
Barbourville, KY 40906
Phone (606) 546-9287

315 Hospital Dr
Ste 2
Barbourville, KY 40906
Phone (606) 546-4060

140 Bryan Blvd
Corbin, KY 40701
Phone (606) 523-2005

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1386274850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1150",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409065150",
            "telephone_number": "606-627-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "CASSIE",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.