MARTIN VAUGHN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1003025826

MARTIN VAUGHN (CRNA) is a healthcare provider. based in Poplar bluff, Missouri. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2005030753 (MO). The NPI Number for MARTIN VAUGHN (CRNA) is 1003025826

Main info

Male
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
MARTIN VAUGHN (CRNA)
NPI
1003025826
Phone
(573) 785-7721
Address
2620 N WESTWOOD BLVD
Enumeration Date
21 May 2007
Last Update Date
15 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8709361000
Graduation Year
2001 (25 years ago)
PAC ID
5395795942
Group Practice PAC ID
8921359712
Professional Enrollment ID
I20050316000946
Address ID
AR724058413JO4800XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness85
Years active:19State licenses:2Digital endpointsOther names

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

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Provider Addresses for MARTIN VAUGHN (CRNA)

  • 2620, North Westwood Boulevard, Loma Linda, Poplar Bluff, Butler County, Missouri, 63901, United States

    POPLAR BLUFF, MO 639013396

    Phone: (573) 785-7721

    Type: Location

  • 782, Paragould Drive, Glendale, Jonesboro, Craighead County, Arkansas, 72405, United States

    JONESBORO, AR 72401

    Phone: (870) 972-9454

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $32.

Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.

Last reported payment date: 2024-02-21 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($32).

Total Amount

$32

General + Research + Ownership

Payments

2

Total payment records

General Amount

$32

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$32
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-03-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050316000946ICertified Registered Nurse Anesthetist (Crna)ARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921359712View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)NV
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)TN

Reviews

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Frequently asked questions

What NPI should I save for MARTIN VAUGHN (CRNA)?
Save NPI 1003025826 if you need a stable reference for MARTIN VAUGHN (CRNA).
Does this profile mean MARTIN VAUGHN (CRNA) is currently active?
Yes — MARTIN VAUGHN (CRNA) appears active in the national provider directory.
What field does MARTIN VAUGHN (CRNA) work in?
You can think of MARTIN VAUGHN (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where does public data place MARTIN VAUGHN (CRNA)?
The snapshot lists Poplar Bluff, Missouri for MARTIN VAUGHN (CRNA); download NPPES for the complete set.
How can I contact MARTIN VAUGHN (CRNA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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