KAITLIN NICOLE VAUGHAN (PT, DPT) – Physical Therapist, NPI 1104621879

KAITLIN NICOLE VAUGHAN (PT, DPT) is a healthcare provider. based in Bakersfield, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 2025008447 (MO). The NPI Number for KAITLIN NICOLE VAUGHAN (PT, DPT) is 1104621879

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
KAITLIN NICOLE VAUGHAN (PT, DPT)
NPI
1104621879
Phone
(636) 697-5745
Address
699 COUNTY ROAD 558
Enumeration Date
17 February 2025
Last Update Date
28 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9073740992
Graduation Year
2022 (4 years ago)
PAC ID
3577087501
Group Practice PAC ID
0941228548
Professional Enrollment ID
I20260318004007
Address ID
AK997013175FA1275XWAYX309
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,541 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

Provider Addresses for KAITLIN NICOLE VAUGHAN (PT, DPT)

  • 699 COUNTY ROAD 558

    BAKERSFIELD, MO 656098051

    Phone: (636) 697-5745

    Type: Mailing

  • 366 COUNTRY MEADOW LN

    FULTON, MO 652515278

    Phone: (573) 642-7216

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-08-14

PECOS data refreshed: 2026-06-15

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
I20250814001102IPhysical Therapist In Private PracticeWYTBD

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 65609)

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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: 0941228548View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAK
-AK
-AK
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Does KAITLIN NICOLE VAUGHAN (PT, DPT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KAITLIN NICOLE VAUGHAN (PT, DPT) uses 1104621879.
Does CMS list KAITLIN NICOLE VAUGHAN (PT, DPT) as active?
Yes — KAITLIN NICOLE VAUGHAN (PT, DPT) is active in the NPI listing used on this page.
What is KAITLIN NICOLE VAUGHAN (PT, DPT) best known for clinically?
Directory data describes KAITLIN NICOLE VAUGHAN (PT, DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does KAITLIN NICOLE VAUGHAN (PT, DPT) list a practice location?
Patients near Bakersfield, Missouri may find KAITLIN NICOLE VAUGHAN (PT, DPT) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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