Traci Lydricka Vaughn, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

023914 Issued in LA

Practice address

221 W Hickory Ave
Bastrop, LA 71220-4551

Phone

(318) 281-6111

Fax

(318) 281-4429

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Louisiana State University School of Medicine in New Orleans Faculty G

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526

  LA

  Medicare reassignment NPD
• Traci Vaughn, M.D., P.a.

  • Otolaryngology Physician
  • Beaumont, TX
  • NPI 1457593626

  Otolaryngology

  NPD (past) Authorized official
• Louisiana State University School of Medicine in New Orleans Faculty G

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Ea Health Physicians Medical Group - National LLC

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1427322981
  NPD (past)
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1083949184

  Otolaryngology

  NPD (past)
• Professional Imaging, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Humble, TX
  • NPI 1902835895
  NPD (past)
• Timberland Medical Group

  • Family Medicine Physician
  • Cedar Park, TX
  • NPI 1528061157

  Otolaryngology

  NPD (past)
• Village Chiropractic and Wellness P.L.L.C.

  • Chiropractor
  • League City, TX
  • NPI 1972750719
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1902840697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NATCHITOCHES ST",
            "address_2": "APT 104",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712913161",
            "telephone_number": "504-376-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W HICKORY AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204551",
            "telephone_number": "318-281-6111",
            "fax_number": "318-281-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "TRACI",
        "middle_name": "LYDRICKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "023914",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "M3777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8H8818",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyesha Turner
• Carl Tilghman Turpin Jr., DDS
• Chukwudi B Uchendu, M.D.
• Karen Lajune Underwood, PH.D, LPC
• V & B Medical Transportation LLC.
• Lauren Vyvial, FNP
• W I Moore Inc
• W.I. Moore Inc
• Jessica Wade
• Wal-Mart Stores East LP

• All providers in Bastrop, LA
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.