POLLY S VAUGHAN CRNP
NPI 1063609287
Nurse Practitioner - Psychiatric/Mental Health in Wilmington, OH

Active since October 02, 2007PECOS EnrolledAccepts Medicare Assignment
84.5/100
CMS Quality Rating
140 FAIRWAY DR, WILMINGTON, OH 45177(937) 974-5591(937) 730-0023 Get Directions Write a Review

NPPES record last updated: May 17, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 17, 2026, Jun 13, 2018 (2 updates tracked since 2018).

About Polly S Vaughan Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

POLLY S VAUGHAN CRNP (NPI 1063609287) is an individual psychiatric/mental health provider in Wilmington, Ohio, licensed in Ohio (APRN.CNP.09551) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS, is affiliated with Kettering Health Miamisburg, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1063609287
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NamePOLLY S VAUGHANCredential: CRNP
Location Address140 FAIRWAY DRWilmington, OH 45177-8008
Mailing Address6100 Gurneyville RdWilmington, OH 45177-6508 · (937) 313-4400 · Fax (937) 488-1414
Fax(937) 730-0023
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateOctober 2, 2007
Last NPPES UpdateMay 17, 20262 updates tracked since enumeration
NPPES CertifiedMay 17, 2026
NPI 1063609287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in OH · APRN.CNP.09551
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN.CNP.09551 (OH)
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License NP-09551 (OH)
140 FAIRWAY DR, Wilmington, OH 45177

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Polly S Vaughan Crnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375625320
PECOS Enrollment IDI20080129000682
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
66 services62 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
49 services31 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kettering Health Miamisburg

Acute Care Hospitals · Miamisburg, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360239
Location4000 Miamisburg-Centerville RoadMiamisburg, OH 45342 · Montgomery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45177 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.16
Promoting Interoperability100
Improvement Activities40
Cost67.18

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
140 FAIRWAY DR
WILMINGTON, OH 45177

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063609287, enumerated as an "individual" on October 02, 2007.

The provider is located at 140 FAIRWAY DR WILMINGTON, OH 45177 and the phone number is (937) 974-5591.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to verify.

Polly Vaughan is affiliated with: KETTERING HEALTH MIAMISBURG.