Active NPI
Andrea Lynn Vaughan, MS, CCC-SLP
- Speech-Language Pathologist
- Saint Louis, MO
National Provider Identifier
1720312721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2009012465
- Practice address
- 3750 Lindell Blvd
Saint Louis University
Saint Louis, MO 63108 - Phone
- (618) 231-5748
- NPI assigned
- Sep 23, 2009
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2009012465 | MO | Primary |
Addresses
Primary practice location
3750 Lindell Blvd
Saint Louis University
Saint Louis, MO 63108
Mailing address
2 Chesapeake TRL
Columbia, IL 62236-4360
Phone (618) 231-5748
Other practice location 1
3625 Magnolia Ave
Saint Louis, MO 63110-4048
Phone (314) 771-2990 ext. 247
Other practice location 2
1027 Bellevue Ave Ste 142
Saint Louis, MO 63117-1851
Phone (618) 231-5748
Other names 1
- Mrs. Andrea Lynn Taylor
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009012465 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1720312721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CHESAPEAKE TRL",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "622364360",
"telephone_number": "618-231-5748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 LINDELL BLVD",
"address_2": "SAINT LOUIS UNIVERSITY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63108",
"telephone_number": "618-231-5748"
}
],
"practiceLocations": [
{
"address_1": "3625 Magnolia Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631104048",
"country_code": "US",
"telephone_number": "314-771-2990 x247",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1027 Bellevue Ave Ste 142",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631171851",
"country_code": "US",
"telephone_number": "618-231-5748",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHAN",
"first_name": "ANDREA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2009012465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "TAYLOR",
"middle_name": "LYNN",
"prefix": "MRS.",
"credential": "MS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.