Individual provider Active NPI

Victor Leslie Vaughn Jr.

  • Peer Specialist
  • Cleveland, OH
National Provider Identifier
1548823768
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0002286 Issued in OH
Practice address
3214 Prospect Ave E
Cleveland, OH 44115-2614
Phone
(216) 910-9015
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 0002286 OH Primary

Addresses

Primary practice location

3214 Prospect Ave E
Cleveland, OH 44115-2614

Mailing address

11841 Lake Ave Apt 18
Lakewood, OH 44107-1802
Phone (440) 454-4379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0002286OHMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Urbanmotivators LLC Peer Specialist CurrentSince May 7, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1548823768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11841 LAKE AVE APT 18",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071802",
            "telephone_number": "440-454-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 PROSPECT AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152614",
            "telephone_number": "216-910-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "VICTOR",
        "middle_name": "LESLIE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0002286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.