Individual provider Active NPI

Ericka Vaughn, FNP-C

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1942771506
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11574 Issued in AZ
Practice address
2905 W Warner Rd Ste 12
Chandler, AZ 85224-1674
Phone
(480) 831-8457
Fax
(480) 491-3112
NPI assigned
Dec 7, 2018
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP11574 AZ Primary

Addresses

Primary practice location

2905 W Warner Rd Ste 12
Chandler, AZ 85224-1674

Mailing address

2905 W Warner Rd Ste 12
Chandler, AZ 85224-1674
Phone (480) 831-8457

Other practice location 1

2721 S San Tan Village Pkwy Ste 104
Gilbert, AZ 85295-0713
Phone (480) 837-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128001949 AZ Practitioner - Nurse Practitioner 4082951165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2905 W Warner Rd
Suite 12
Chandler, AZ 85224-1674
Phone (480) 831-8457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP11574AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Warner Family Practice, PC CurrentSince Aug 20, 2020 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Jun 1, 2024 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

2905 W Warner Rd
Chandler, AZ 85224
Phone (480) 603-9000

2905 W Warner Rd
Ste 12
Chandler, AZ 85224
Phone (480) 831-8457

2001 N 4th St
Flagstaff, AZ 86004
Phone (928) 526-5020

21300 N John Wayne Pkwy
Ste 123
Maricopa, AZ 85139
Phone (520) 494-7778

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

Interoperability endpoints

  • Direct secure messaging: evaughn120748@westdirect.optum.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1942771506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD STE 12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD STE 12",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-831-8457",
            "fax_number": "480-491-3112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2721 S San Tan Village Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852950713",
            "country_code": "US",
            "telephone_number": "480-837-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "ERICKA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.