Individual provider Active NPI

Grace Kathryn Vaughn, PA-C

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1801600218
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5601013029 Issued in MI
Practice address
309 Jefferson Ave SE
Grand Rapids, MI 49503-4558
Phone
(844) 237-3627
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5601013029 MI Primary

Addresses

Primary practice location

309 Jefferson Ave SE
Grand Rapids, MI 49503-4558

Mailing address

326 Dean St NE
Grand Rapids, MI 49505-4735
Phone (989) 798-3037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000219 MI Practitioner - Physician Assistant 3072039643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

1150 E Sherman Blvd
Suite 1100
Muskegon, MI 49444-4607
Phone (231) 672-2203

15151 Stanton St
West Olive, MI 49460-8543
Phone (616) 685-1950

2006 Holton Rd
Muskegon, MI 49445-1505
Phone (231) 672-3333

3570 Henry St
Norton Shores, MI 49441-4576

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601013029MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Network Family Medicine CurrentSince Apr 1, 2025 Accepting new patients

Locations

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

Interoperability endpoints

  • Direct secure messaging: gvaughn3048503@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1801600218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 DEAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054735",
            "telephone_number": "989-798-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034558",
            "telephone_number": "844-237-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "GRACE",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601013029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.