Individual provider Active NPI

Elisabeth Vaughn, OTR/L

  • Occupational Therapist
  • Saint Charles, MO
National Provider Identifier
1598532533
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2023030940 Issued in MO
Practice address
1552 Country Club Plaza Dr Unit 1570
Saint Charles, MO 63303-3859
Phone
(636) 724-1127
NPI assigned
Dec 11, 2023
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2023030940 MO Primary

Addresses

Primary practice location

1552 Country Club Plaza Dr Unit 1570
Saint Charles, MO 63303-3859

Mailing address

2232 S Grand Blvd Apt 208
Saint Louis, MO 63104-1666
Phone (407) 912-2480

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
2023030940MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC PastSince Dec 17, 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, 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": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1598532533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 S GRAND BLVD APT 208",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041666",
            "telephone_number": "407-912-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COUNTRY CLUB PLAZA DR UNIT 1570",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033859",
            "telephone_number": "636-724-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "ELISABETH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2023030940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.