Individual provider Active NPI

Kelli Phelps Vaughan, RPH

  • Pharmacist
  • Thomaston, GA
National Provider Identifier
1881295970
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
014312 Issued in GA
Practice address
855 N Church St
Thomaston, GA 30286-3622
Phone
(706) 648-2109
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 014312 GA Primary

Addresses

Primary practice location

855 N Church St
Thomaston, GA 30286-3622

Mailing address

1295 Hendricks Church Rd
Thomaston, GA 30286-2042

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
014312GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1881295970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 HENDRICKS CHURCH RD",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N CHURCH ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863622",
            "telephone_number": "706-648-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "KELLI",
        "middle_name": "PHELPS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "014312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.