Active NPI
Jillian Vaughan
- Family Nurse Practitioner
- Boise, ID
National Provider Identifier
1437758489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 53890
- Practice address
- 301 W Myrtle St
Boise, ID 83702-7656 - Phone
- (208) 342-8200
- NPI assigned
- Oct 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroscience Registered Nurse | 163WN0800X | 53890 | ID | |
| Family Nurse Practitioner | 363LF0000X | 53890 | ID | Primary |
Addresses
Primary practice location
301 W Myrtle St
Boise, ID 83702-7656
Mailing address
6293 N Portsmouth Ave
Boise, ID 83714-6111
Phone (541) 961-4735
Other practice location 1
16111 N Brinson St # 110
Nampa, ID 83687-5509
Phone (208) 906-1600
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jillian@idahoasr.com | Direct | |
| Direct Messaging Address | jillian@idahoASR.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
301 W Myrtle St
Boise, ID 83702-7656
Phone (208) 342-8200
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- Saint Alphonsus Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53890 | ID | MD | Neuroscience Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christopher Vaughan, MD PLLC | Multi-Specialty | Current | Accepting new patients |
Locations
301 W Myrtle St
Boise, ID 83702
Phone (208) 322-5922
Organizations & group practices 1
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.
-
- Interventional Pain Medicine Physician
- Boise, ID
- NPI 1376244061
Multi-Specialty
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1437758489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6293 N PORTSMOUTH AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837146111",
"telephone_number": "541-961-4735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W MYRTLE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837027656",
"telephone_number": "208-342-8200"
}
],
"practiceLocations": [
{
"address_1": "16111 N Brinson St # 110",
"address_purpose": "LOCATION",
"city": "Nampa",
"state": "ID",
"postal_code": "836875509",
"country_code": "US",
"telephone_number": "208-906-1600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHAN",
"first_name": "JILLIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-21",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Neuroscience",
"state": "ID",
"license": "53890",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "53890",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jillian@idahoasr.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "16111 N Brinson St # 110",
"city": "Nampa",
"state": "ID",
"country_code": "US",
"postal_code": "836875509",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jillian@idahoASR.com",
"affiliation": "N",
"endpointDescription": "E-mail",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "E-mail",
"address_1": "16111 N Brinson St # 110",
"city": "Nampa",
"state": "ID",
"country_code": "US",
"postal_code": "836875509",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.