KEELY E VAUGHAN PA-C
NPI 1780060319
Physician Assistant - Medical in Martin, TN

Q: What is Keely Vaughan's NPI number?

The NPI number for Keely Vaughan is 1780060319. It was assigned to this individual provider in the NPPES registry on August 5, 2015.

Q: What is Keely Vaughan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Keely Vaughan was last updated on May 26, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 05, 2015PECOS EnrolledAccepts Medicare Assignment

117 KENNEDY DR, MARTIN, TN 38237(731) 587-9511(877) 309-6416 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 26, 2021, May 21, 2021, Oct 30, 2019 and 1 more (4 updates tracked since 2015).

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About Keely E Vaughan Pa-c NPPES

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

KEELY E VAUGHAN PA-C (NPI 1780060319) is an individual medical provider in Martin, Tennessee, licensed in Tennessee (PA2812) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1780060319

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKEELY E VAUGHANCredential: PA-C

Location Address117 KENNEDY DRMartin, TN 38237-3394

Mailing Address117 Kennedy DrMartin, TN 38237-3309 · (731) 587-9511 · Fax (877) 309-6416

Phone(731) 587-9511

Fax(877) 309-6416

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 5, 2015

Last NPPES UpdateMay 26, 20214 updates tracked since enumeration

NPPES CertifiedMay 26, 2021

✔ NPI 1780060319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in TN · PA2812

117 KENNEDY DR, Martin, TN 38237

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Other Identifiers 5

Other2153951Cigna

Other3815442Amerigroup

Other5440149Bcbs

OtherP01577761Rail Road Medicare

MedicaidQ018026TN

Accepted Insurance

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

Keely E Vaughan Pa-c 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 ID6103133251

PECOS Enrollment IDI20150922001592

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 5

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.

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

48 services23 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

45 services25 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

24 services23 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

19 services13 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636

This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.

14 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Jackson-Madison County General Hospital

Acute Care Hospitals · Jackson, TN

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440002

Location620 Skyline DriveJackson, TN 38301 · Madison County

Emergency services Birthing friendly

Volunteer Community Hospital

Acute Care Hospitals · Martin, TN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number440061

Location161 Mount Pelia RdMartin, TN 38237 · Weakley County

Emergency services Birthing friendly

Baptist Memorial Hospital Union City

Acute Care Hospitals · Union City, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440130

Location1201 Bishop St, PO Box 310Union City, TN 38261 · Obion County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers13 claims25 services$3.68 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers11 claims11 services$66.78 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier11 claims11 services$21.28 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier12 claims12 services$16.97 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers11 claims11 services$8.72 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

1 supplier15 claims15 services$49.02 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 9

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

DR. WALTER FRIZZELL FLETCHER M.D.

Family Medicine