Individual provider Active NPI

Larry D Vaught, PH.D.

  • Psychologist
  • Tulsa, OK
National Provider Identifier
1629141775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
441 Issued in OK
Practice address
5512 S Lewis Ave
Tulsa, OK 74105-7140
Phone
(918) 747-1600
Fax
(918) 749-2774
NPI assigned
Nov 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 441 OK Primary

Addresses

Primary practice location

5512 S Lewis Ave
Tulsa, OK 74105-7140

Mailing address

5512 S Lewis Ave
Tulsa, OK 74105-7140
Phone (918) 747-1600

Other identifiers 3

IdentifierTypeStateIssuer
731351277OtherOKHUMANA
100838930AMedicaidOK
730703797008OtherOKBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120413000067 OK Practitioner - Clinical Psychologist 1052581832 Reassigns benefits to 1 organization
I20220328000306 LA Practitioner - Clinical Psychologist 1052581832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lauren D. Stokes, PH.D., M.P., LLCGroup PAC ID 3971902990, 6 clinicians

Practice addresses (Care Compare)

217 Ansley Blvd
Alexandria, LA 71303-3782
Phone (318) 545-7255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
441OKMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren D Stokes PHD MP LLC CurrentSince Mar 18, 2022 Accepting new patients
Behavioral Health Inc. Psychologist CurrentSince Dec 5, 2011 Accepting new patients
River Parks Developmental Center Psychologist Past Accepting new patients

Locations

217 Ansley Blvd
Alexandria, LA 71303
Phone (318) 422-5743

5512 S Lewis Ave
Tulsa, OK 74105
Phone (918) 510-4554

Organizations & group practices 3

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629141775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057140",
            "telephone_number": "918-747-1600",
            "fax_number": "918-749-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHT",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "731351277",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100838930A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "730703797008",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.