Individual provider Active NPI

Valencia L Vaughn

  • Nurse's Aide
  • Jackson, MS
National Provider Identifier
1851947584
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
A060372 Issued in MS
Practice address
5846 Ridgewood Rd Ste C101
Jackson, MS 39211-2646
Phone
(601) 213-8441
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X A060372 MS Primary

Addresses

Primary practice location

5846 Ridgewood Rd Ste C101
Jackson, MS 39211-2646

Mailing address

5846 Ridgewood Rd Ste C101
Jackson, MS 39211-2646
Phone (601) 213-8441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A060372MSMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1851947584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 RIDGEWOOD RD STE C101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112646",
            "telephone_number": "601-213-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5846 RIDGEWOOD RD STE C101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112646",
            "telephone_number": "601-213-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "VALENCIA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "MS",
            "license": "A060372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.