Individual provider Active NPI

Amelia Ray Vaughn, CRNA

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1639916125
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
230648 Issued in AR
Practice address
9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone
(501) 202-2000
NPI assigned
Jul 11, 2024
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 230648 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr
Little Rock, AR 72205-6321

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 202-2093

Other practice location 1

4301 W Markham St # 515
Little Rock, AR 72205-7101
Phone (501) 686-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108001866 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739613027 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harris and Theodore Anesthesia Services LLCGroup PAC ID 9234374554, 5 clinicians
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

13501 Chenal Pkwy
Suite 102
Little Rock, AR 72211-5262
Phone (501) 451-7843

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 202-2093

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
230648ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Harris and Theodore Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 2, 2026 Accepting new patients
Arkansas Health Group CurrentSince Oct 21, 2024 Accepting new patients
Arkansas Health Group CurrentSince Oct 21, 2024 Accepting new patients
McGowan Court Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2026 Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

151 McGowan Ct
Hot Springs National Park, AR 71913
Phone (501) 623-4101

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1639916125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-202-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 515",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "AMELIA",
        "middle_name": "RAY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "230648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.