Individual provider Active NPI

Amber Marie Vaughn, RN

  • Community Health Registered Nurse
  • Elizabeth, PA
National Provider Identifier
1710576855
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN682774 Issued in PA
Practice address
8866 Roberts Hollow Rd
Elizabeth, PA 15037-3200
Phone
(724) 322-2693
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN682774 PA Primary

Addresses

Primary practice location

8866 Roberts Hollow Rd
Elizabeth, PA 15037-3200

Mailing address

8866 Roberts Hollow Rd
Elizabeth, PA 15037-3200
Phone (724) 322-2693

Other identifiers 1

IdentifierTypeStateIssuer
25624648OtherPADRIVERS

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL TBD

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN682774PAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1710576855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8866 ROBERTS HOLLOW RD",
            "city": "ELIZABETH",
            "state": "PA",
            "postal_code": "150373200",
            "telephone_number": "724-322-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8866 ROBERTS HOLLOW RD",
            "city": "ELIZABETH",
            "state": "PA",
            "postal_code": "150373200",
            "telephone_number": "724-322-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "PA",
            "license": "RN682774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS",
            "identifier": "25624648",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TBD",
            "affiliation": "N",
            "address_1": "8866 Roberts Hollow Rd",
            "city": "Elizabeth",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150373200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elizabeth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.