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

Last updated

Jan 8, 2015By the provider in NPPES

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

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

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

  dba LSU Healthcare Network

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526
  Medicare reassignment NPD
• Vaughn Medical Consulting

  • Otolaryngology Physician
  • Zachary, LA
  • NPI 1679015010
  Authorized official Same address or phone
• Traci Vaughn, M.D., P.a.

  • Otolaryngology Physician
  • Beaumont, TX
  • NPI 1457593626
  NPD (past) Authorized official
• Louisiana State University School of Medicine in New Orleans Faculty G

  dba Lsu Healthcare Network

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Morehouse General Hospital

  dba Morehouse Family Medicine Rural Health Clinic

  • Rural Health Clinic/Center
  • Bastrop, LA
  • NPI 1992207294
  NPD (past)
• Ea Health Physicians Medical Group - National LLC

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

  dba MaineGeneral Speciality Care

  • 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.

  dba Cornerstone Chiropractic

  • 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": [],
    "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 (Walmart Pharmacy 10-0098)

• Otolaryngology Physician in Bastrop, LA
• Providers in Bastrop, LA by specialty
• 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.