Individual provider Active NPI

Taylor Vaughn

  • Behavior Technician
  • Grand Rapids, MI
National Provider Identifier
1740795822
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2814 Woodcliff Cir SE
Grand Rapids, MI 49506
Phone
(855) 832-6727
NPI assigned
Dec 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2814 Woodcliff Cir SE
Grand Rapids, MI 49506

Mailing address

2814 Woodcliff Cir SE
Grand Rapids, MI 49506-3155
Phone (855) 832-6727

Other practice location 1

8712 Douglas Ave
Kalamazoo, MI 49009-6399
Phone (693) 708-3032

Other practice location 2

8712 Douglas Ave
Kalamazoo, MI 49009-6399
Phone (693) 708-3032

Other identifiers 1

IdentifierTypeStateIssuer
810764147MedicaidMI

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

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1740795822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 WOODCLIFF CIR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063155",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 WOODCLIFF CIR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49506",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8712 Douglas Ave",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490096399",
            "country_code": "US",
            "telephone_number": "693-708-3032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8712 Douglas Ave",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490096399",
            "country_code": "US",
            "telephone_number": "693-708-3032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810764147",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.