Kimberly Vaughn, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN081967 Issued in GA

Practice address

138 Mitchell Dr
Summerville, GA 30747-6642

Phone

(706) 331-5913

NPI assigned

Mar 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Shepherd Resources

  • Clinic/Center
  • Trion, GA
  • NPI 1134490048
  NPD (past)
• Trion Medical Center Inc.

  • Family Medicine Physician
  • Trion, GA
  • NPI 1396759627
  NPD (past)

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1497053656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MITCHELL DR",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307476642",
            "telephone_number": "706-331-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MITCHELL DR",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307476642",
            "telephone_number": "706-331-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN081967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Elise Smith
• Brandi R Stouder, RPT
• Summerville Chiropractic, Inc.
• Christie Beatrice Tankersley, AGACNP-BC
• Joanna Bruce Tucker
• Brenda Veatch-Haynes, FNP-BC
• Wal-Mart Stores East, LP
• Cheryl C Weems, RBT
• Mary Wilson
• Kaylie Womack

• Family Nurse Practitioner in Summerville, GA
• Providers in Summerville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.