Individual provider Active NPI

Nicholas R Vaughan, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1487027728
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43-557385 Issued in KS
Practice address
5721 W 119TH St
Overland Park, KS 66209-3722
Phone
(913) 428-2900
Fax
(913) 428-2951
NPI assigned
Nov 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 114015 KS
Certified Registered Nurse Anesthetist 367500000X 2022046624 MO
Certified Registered Nurse Anesthetist 367500000X 43-557385 KS Primary

Addresses

Primary practice location

5721 W 119TH St
Overland Park, KS 66209-3722

Mailing address

8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Phone (913) 428-2900

Other practice location 1

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160311000518 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698071025 Reassigns benefits to 7 organizations
I20230525001596 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698071025 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians
Anesthesia Associates of Topeka PAGroup PAC ID 5698675437, 54 clinicians
Anesthesia Associates of Kansas City PAGroup PAC ID 1951206168, 214 clinicians
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

1500 SW 10H Ave
Topeka, KS 66604-1301

19600 E 39TH St
Centerpoint Medical Center
Independence, MO 64057-2301
Phone (816) 698-7000

3901 Rainbow Blvd
Kansas City, KS 66160-7415
Phone (913) 588-3315

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

5721 W 119TH St
Menorah Medical Center
Overland Park, KS 66209-3722
Phone (913) 498-6000

823 SW Mulvane St
Suite 210
Topeka, KS 66606-1679
Phone (785) 235-3451

Hospital & facility affiliations

  • Overland Park Reg Med Ctr Hospital, Overland Park, KS, CCN 170176
  • Adventhealth South Overland Park, Inc Hospital, Overland Park, KS, CCN 170208
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
114015KSMDRegistered Nurse
43-557385KSMDCertified Registered Nurse Anesthetist
2022046624MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Feb 8, 2016 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Dec 28, 2023 Accepting new patients
Saint Lukes Physician Group Inc CurrentSince Feb 1, 2023 Accepting new patients
Meritas Health Corporation CurrentSince Nov 6, 2023 Accepting new patients
Midwest Anesthesia Associates, PA Registered Nurse CurrentSince Dec 5, 2023 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Kansas Anesthesiology Professionals PA CurrentSince Apr 26, 2023 Accepting new patients
Kansas University Physicians Inc CurrentSince Dec 28, 2023 Accepting new patients
Meritas Health Corporation CurrentSince Nov 6, 2023 Accepting new patients
Kansas Surgery Center, LLC CurrentSince Apr 26, 2023 Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

10995 Quivira Rd
Overland Park, KS 66210
Phone (913) 685-2211

10995 Quivira Rd
Ste 200
Overland Park, KS 66210

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

9301 W 74th St
Ste 300
Shawnee Msn, KS 66204
Phone (913) 632-9300

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

19550 E 39th St S
Ste 100
Independence, MO 64057
Phone (816) 478-2600

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1487027728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST",
            "address_2": "SUITE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102144",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093722",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Clay Edwards Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163254",
            "country_code": "US",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "114015",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2022046624",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-557385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.