Individual provider Active NPI

Rebecca Erin Vaughn, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1629110176
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000013049 Issued in TN
Practice address
1120 Sams St
Cookeville, TN 38506-4006
Phone
(931) 528-7312
Fax
(931) 528-7377
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN0000124117 TN
Family Nurse Practitioner 363LF0000X APN0000013049 TN Primary

Addresses

Primary practice location

1120 Sams St
Cookeville, TN 38506-4006

Mailing address

108 Reed Mill LN
Monroe, TN 38573-5613
Phone (931) 823-8688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921002076 TN Practitioner - Nurse Practitioner 1759698939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John R CloughGroup PAC ID 6103980305, 8 clinicians

Practice addresses (Care Compare)

5751 Bradford Hicks Dr
Livingston, TN 38570-2237
Phone (931) 823-3030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN0000124117TNMDRegistered Nurse
APN0000013049TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John R Clough CurrentSince Jul 9, 2015 Accepting new patients

Locations

5751 Bradford Hicks Dr
Livingston, TN 38570
Phone (931) 400-5154

Interoperability endpoints

  • Direct secure messaging: rebeccavaughn@pcl-tn.direct.office.nextgen.com

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.

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1629110176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 REED MILL LN",
            "city": "MONROE",
            "state": "TN",
            "postal_code": "385735613",
            "telephone_number": "931-823-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SAMS ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385064006",
            "telephone_number": "931-528-7312",
            "fax_number": "931-528-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "REBECCA",
        "middle_name": "ERIN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000124117",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000013049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.