Storm Bradley Vaughn, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

AA484 Issued in FL

Practice address

11109 Parkview Plaza Dr
Fort Wayne, IN 46845

Phone

(260) 425-6030

Fax

(260) 425-6028

NPI assigned

Jun 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Enrollment records 2

Specialty

Anesthesiology Assistant

Education

Emory University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Miami Anesthesia Services LLCGroup PAC ID 1355651837, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Miami Anesthesia Services LLC

  • Anesthesiology Physician
  • Aventura, FL
  • NPI 1821475179
  Medicare reassignment Care Compare group NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012
  Medicare reassignment NPD
• Anesthesiology Associates of Tallahassee Inc

  • Anesthesiology Physician
  • Tallahassee, FL
  • NPI 1922772037
  Medicare reassignment NPD
• South Georgia Anesthesia Associates, PC

  • Pain Medicine (Anesthesiology) Physician
  • Thomasville, GA
  • NPI 1285605733

  Anesthesiologist Assistant

  Medicare reassignment NPD
• St Lucie Anesthesia Associates LLC

  • Anesthesiology Physician
  • Boca Raton, FL
  • NPI 1700044252
  Medicare reassignment NPD
• Anesthesiology Associates of Tallahassee Inc

  • Anesthesiology Physician
  • Tallahassee, FL
  • NPI 1770257883
  NPD
• St. Lucie Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Boca Raton, FL
  • NPI 1184398257
  NPD
• St. Lucie Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Boca Raton, FL
  • NPI 1851252902
  NPD
• Anesthesiology Associates of Tallahassee Inc

  • Anesthesiology Physician
  • Tallahassee, FL
  • NPI 1831171990
  NPD (past)

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1780179333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 NEW VISION DR BLDG B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-425-6030",
            "fax_number": "260-425-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Miccosukee Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085037",
            "country_code": "US",
            "telephone_number": "850-431-1155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Miccosukee Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085037",
            "country_code": "US",
            "telephone_number": "850-431-1155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "STORM",
        "middle_name": "BRADLEY",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000046A",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA484",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Vasquez, PHARMD
• Alison Nicol Vaughan, OTD
• Krista Vaughan, OT
• Deanna Lynn Vaughn, NP
• Mekayla Vaughn, RBT
• Veronica A Vaughn, MSW, LCSW
• Kevin Alton Vaught, MD
• Mohammad Ali Vaziri, M.D.
• Brenda Vazquez, MD
• Emilio J Vazquez, MD

• Anesthesiologist Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiologist Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.