Individual provider Active NPI

Jennifer Bryant Vaughn, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1386809408
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3567 Issued in SC
Practice address
1809 Wade Hampton Blvd Ste 120
Greenville, SC 29609-4050
Phone
(864) 522-5000
Fax
(864) 241-9275
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3567 SC Primary

Addresses

Primary practice location

1809 Wade Hampton Blvd Ste 120
Greenville, SC 29609-4050

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20090211000739 SC Practitioner - Nurse Practitioner 6800951658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

1809 Wade Hampton Blvd
Suite 120
Greenville, SC 29609-4050
Phone (864) 522-5000

Hospital & facility affiliations

  • Interim Healthcare of the Upstate Home health agency, Greenville, SC, CCN 427015
  • Prisma Health Home Health-Upstate Home health agency, Greenville, SC, CCN 427029
  • Bayada Home Health Care Greenville Home health agency, Greenville, SC, CCN 427137
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3567SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 26, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 26, 2020 Accepting new patients
Moss Enterprise PastSince Sep 27, 2015 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste C300
Greenville, SC 29615
Phone (864) 454-2852

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

1809 Wade Hampton Blvd
Ste 120
Greenville, SC 29609
Phone (864) 322-4665

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

340 Medical Pkwy
Ste 250
Greer, SC 29650
Phone (864) 797-9480

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

Interoperability endpoints

  • Direct secure messaging: jvaughn12436@direct.ghs.myhfn.org

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.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1386809408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 WADE HAMPTON BLVD STE 120",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296094050",
            "telephone_number": "864-522-5000",
            "fax_number": "864-241-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "JENNIFER",
        "middle_name": "BRYANT",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.