Individual provider Active NPI

Sydney Vaughn, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1811739758
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
370 Knollwood St Ste 300
Winston Salem, NC 27103-1864
Phone
(336) 252-4440
NPI assigned
Jun 11, 2024
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

370 Knollwood St Ste 300
Winston Salem, NC 27103-1864

Mailing address

3830 Overview Dr
Clemmons, NC 27012-9163
Phone (336) 813-9021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241016002262 NC Practitioner - Physician Assistant 3678005527 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
Group practices
Apogee Behavioral Medicine PCGroup PAC ID 6204218357, 64 clinicians

Practice addresses (Care Compare)

370 Knollwood St
Suite 301
Winston Salem, NC 27103-1835
Phone (336) 252-4440

445 Dolley Madison Rd
Suite 100
Greensboro, NC 27410-5166
Phone (336) 967-6596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: apogeebehavioralmedicine.sydneyvaughn@153105.advancedmd-direct.com

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1811739758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 OVERVIEW DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129163",
            "telephone_number": "336-813-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 KNOLLWOOD ST STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031864",
            "telephone_number": "336-252-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "SYDNEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.