Individual provider Active NPI

Raquel Vaughan, NP

  • Acute Care Clinical Nurse Specialist
  • Memphis, TN
National Provider Identifier
1407958382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
APN0000008334 Issued in TN
Practice address
8060 Wolf River Blvd
Memphis, TN 38138-1727
Phone
(901) 271-2272
Fax
(901) 271-2161
NPI assigned
Sep 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X APN0000008334 TN Primary

Addresses

Primary practice location

8060 Wolf River Blvd
Memphis, TN 38138-1727

Mailing address

8060 Wolf River Blvd
Memphis, TN 38138-1727
Phone (901) 271-2272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120724000893 MS Practitioner - Nurse Practitioner 1153369236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians

Practice addresses (Care Compare)

100 Baptist Memorial Cir
Suite 201
Oxford, MS 38655-4476
Phone (901) 271-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000008334TNMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksdale Hma LLC Past Accepting new patients

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, 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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407958382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-2272",
            "fax_number": "901-271-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-2272",
            "fax_number": "901-271-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "RAQUEL",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "TN",
            "license": "APN0000008334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.