Joy Vaughan, PA
Individual provider Active NPI Medical Physician Assistant · Spokane, WA
NPI 1780413484 · NPPES record last updated Oct 30, 2024
Key facts
- NPI
- 1780413484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA61617034 (WA)
- Practice address
- 2020 E 29TH Ave Lowr Level
Spokane, WA 99203-3917 - Phone
- (509) 626-9400
- Fax
- (509) 626-9401
- NPI assigned
- Jul 30, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Health and Services Washington
Practice addresses (Care Compare)
1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701
2020 E 29TH Ave
Lowr Level
Spokane, WA 99203-3917
Phone (509) 626-9400
Hospital & facility affiliations
- Prov Sacred HRT Med Ctr & Childs Hosp.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241106003328 | WA | Practitioner - Physician Assistant | 4284168717 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA61617034 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current |
Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
2020 E 29th Ave
Lowr
Spokane, WA 99203
Phone (509) 626-9400
Interoperability endpoints
- jrimel1774025@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA61617034 | WA | Yes |
Addresses
Primary practice location
2020 E 29TH Ave Lowr Level
Spokane, WA 99203-3917
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
NPI Registry JSON
{
"created_epoch": "1722297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1780413484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 E 29TH AVE LOWR LEVEL",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992033917",
"telephone_number": "509-626-9400",
"fax_number": "509-626-9401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "JOY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-30",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA61617034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
- Alison Dawn Vasan
- Estera Vasilache
- Yelizaveta Vasilyev
- Roger Vasquez
- Annamarie Rose Vaughan
- Christina Vaughn
- Vicki Vaught
- Helenna L Vaupel
- Bianca Vavrica
- Tim K. Vawter
All providers in Spokane, WA · Medical Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.