Individual provider Active NPI

Bailey Vaughan

  • School Psychologist
  • Roanoke, VA
National Provider Identifier
1760201107
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
PPS-0608841 Issued in VA
Practice address
40 Douglas Ave NW
Roanoke, VA 24012-4611
Phone
(540) 853-6316
NPI assigned
Oct 3, 2024
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X PPS-0608841 VA Primary

Addresses

Primary practice location

40 Douglas Ave NW
Roanoke, VA 24012-4611

Mailing address

40 Douglas Ave NW
Roanoke, VA 24012-4611

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

State licenses

LicenseStateTypeSpecialty
PPS-0608841VAMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke City Public Schools PastSince Oct 6, 2024 Accepting new patients

Organizations & group practices 1

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": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1760201107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DOUGLAS AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240124611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DOUGLAS AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240124611",
            "telephone_number": "540-853-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "BAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "PPS-0608841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.