Kelly Ann Vaughn, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

2012024479 Issued in MO

Practice address

701 S 8TH St
Clinton, MO 64735-2901

Phone

(660) 885-2237

NPI assigned

Oct 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services OT Mo LLCGroup PAC ID 4587089925, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Rehabilitation Services OT Mo LLC

  dba Fox Rehabilitation

  • Occupational Therapist
  • Saint Charles, MO
  • NPI 1386269363
  Medicare reassignment Care Compare group NPD
• Clinton School District #124

  • Local Education Agency (LEA)
  • Clinton, MO
  • NPI 1508142787
  NPD (past)

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1851933204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 LINCOLN ST",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801193",
            "telephone_number": "417-454-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S 8TH ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352901",
            "telephone_number": "660-885-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "2012024479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twin Lakes Hospice Inc.
• Tonya Tyler, MSN, RN, PMHNP-BC
• Amanda Sue Underwood, R.N.
• Aneel Ahmed Ursani, M.D.
• Valudental Clinton LLC (Celebrate Dental & Braces)
• Sara Jean Vaughn, LPC
• Georgia Vest, RBT
• Elaine Ann Vignola, LCSW
• Jami Suzann Voelmeck, M.A., CCC-SLP
• Mark D Vogt, D.O.

• Pediatric Occupational Therapist in Clinton, MO
• Providers in Clinton, MO by specialty
• Pediatric Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.