DOMINIQUE NICOLE VAUGHN AGNP-C
NPI 1124884895
Nurse Practitioner - Gerontology in Cordova, TN

Q: What is Dominique Vaughn's NPI number?

The NPI number for Dominique Vaughn is 1124884895. It was assigned to this individual provider in the NPPES registry on February 21, 2024.

Q: What is Dominique Vaughn's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Dominique Vaughn was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 21, 2024PECOS Enrolled

682 WOODLAND FOX LN W, CORDOVA, TN 38018(901) 436-0542 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2025, May 10, 2025, Feb 17, 2025 (3 updates tracked since 2025).

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About Dominique Nicole Vaughn Agnp-c NPPES

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

DOMINIQUE NICOLE VAUGHN AGNP-C (NPI 1124884895) is an individual gerontology provider in Cordova, Tennessee, licensed in Tennessee (35863) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124884895

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameDOMINIQUE NICOLE VAUGHNCredential: AGNP-C

Location Address682 WOODLAND FOX LN WCordova, TN 38018-1147

Mailing Address682 Woodland Fox Ln WCordova, TN 38018-1147

Phone(901) 436-0542

Sole ProprietorNo

Enumeration DateFebruary 21, 2024

Last NPPES UpdateMay 12, 20253 updates tracked since enumeration

NPPES CertifiedMay 12, 2025

✔ NPI 1124884895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in TN · 35863

682 WOODLAND FOX LN W, Cordova, TN 38018

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominique Nicole Vaughn Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Dominique Vaughn reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Total Extended Care Services PC

442 mi

Physical Medicine & Rehabilitation

600 W NATIONAL RD
Englewood, OH 45322

Reassigned Medicare billing, Tennessee enrollment
44 clinicians in this Medicare group

NPI 1699522029 (937) 540-0409

Theoria Medical

609 mi

Internal Medicine

41800 W 11 MILE RD STE 109
Novi, MI 48375

Reassigned Medicare billing, Tennessee enrollment
93 clinicians in this Medicare group

NPI 1609362375 (248) 860-4634

Complexcare Medical Group Mid-Atlantic H PLLC

609 mi

Internal Medicine

41800 W 11 MILE RD STE 109
Novi, MI 48375

Reassigned Medicare billing, Tennessee enrollment
18 clinicians in this Medicare group

NPI 1275427429 (248) 660-1220

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

34 services19 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38018 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Vaughn's NPI number?

The NPI number for Dominique Vaughn is 1124884895. It was assigned to this individual provider in the NPPES registry on February 21, 2024.

Where is Dominique Vaughn located?

Dominique Vaughn practices at 682 Woodland Fox Ln W, Cordova, TN 38018. The listed phone number is (901) 436-0542.

What is Dominique Vaughn's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Dominique Vaughn enrolled in Medicare?

Yes. Dominique Vaughn is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dominique Vaughn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominique Vaughn reassigns Medicare benefits to 3 organizations: Total Extended Care Services PC (Englewood, OH), Theoria Medical (Novi, MI) and Complexcare Medical Group Mid-Atlantic H PLLC (Novi, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominique Vaughn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dominique Vaughn accept?

Health plans from BlueCross BlueShield of Tennessee and Cigna Healthcare list Dominique Vaughn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominique Vaughn was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.