Crystal Tina Vaughn, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA 04906 Issued in OH

Practice address

2181 Ambleside Dr
Cleveland, OH 44106-4645

Phone

(216) 791-2968

NPI assigned

Apr 19, 2012

Last updated

Apr 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1891052593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 E 128TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441082447",
            "telephone_number": "216-799-2191",
            "fax_number": "216-791-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 AMBLESIDE DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064645",
            "telephone_number": "216-791-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "CRYSTAL",
        "middle_name": "TINA",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA 04906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyetta Vaughn-Pritchett
• Alyssa Vaughn
• Audra Vaughn
• Brittany Vaughn, M.ED.
• Cory Vaughn
• Desirae Vaughn, LPN
• Jasmine Vaughn
• Kayla Vaughn, QMHS CMS
• Octavia Sjhanette Vaughn
• Sydni Marie Vaughn

• Occupational Therapy Assistant in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.