Individual provider Active NPI

Molly E Vaughan

  • Gerontology Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1821695578
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024180307 Issued in VA
Practice address
1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone
(434) 200-5925
NPI assigned
Oct 6, 2020
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024180307 VA Primary

Addresses

Primary practice location

1701 Thomson Dr
Lynchburg, VA 24501-1118

Mailing address

72 Trotter LN
Concord, VA 24538-2504
Phone (434) 660-0696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210114001390 VA Practitioner - Nurse Practitioner 1850704750 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians
Health Providers of America LLCGroup PAC ID 9931529948, 97 clinicians

Practice addresses (Care Compare)

1475 Virginia Ave
Harrisonburg, VA 22802-2433
Phone (540) 564-3400

860 Wolf Creek TRL
Abingdon, VA 24210-2536
Phone (864) 593-2935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Dec 16, 2022 Accepting new patients
Health Providers of America, LLC CurrentSince Nov 1, 2025 Accepting new patients
Universal Health Corporation CurrentSince Dec 12, 2022 Accepting new patients
Eventus Premier Healthcare LLC CurrentSince Jan 20, 2025 Accepting new patients
Legacy Care Aco LLC CurrentSince Jun 18, 2023 Accepting new patients
Signify Health, LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

860 Wolf Creek Trl
Abingdon, VA 24210
Phone (276) 628-1621

3737 Catalpa Ave
Buena Vista, VA 24416
Phone (540) 261-7444

1475 Virginia Ave
Harrisonburg, VA 22802
Phone (540) 564-3400

1300 Enterprise Dr
Lynchburg, VA 24502
Phone (434) 200-1816

250 Browns Hill Ct
Midlothian, VA 23114
Phone (424) 328-6526

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

2901 S Lynnhaven Rd
Ste 450
Virginia Beach, VA 23452
Phone (757) 351-4585

780 Lynnhaven Pkwy
Ste 400
Virginia Beach, VA 23452
Phone (201) 581-3411

Organizations & group practices 6

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1821695578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 TROTTER LN",
            "city": "CONCORD",
            "state": "VA",
            "postal_code": "245382504",
            "telephone_number": "434-660-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "MOLLY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024180307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.