POLLY S VAUGHAN (CRNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063609287

POLLY S VAUGHAN (CRNP) is a healthcare provider. based in Wilmington, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. NP-09551 (OH). The NPI Number for POLLY S VAUGHAN (CRNP) is 1063609287

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
POLLY S VAUGHAN (CRNP)
NPI
1063609287
Phone
(937) 313-4400
Address
6100 GURNEYVILLE RD
Enumeration Date
2 October 2007
Last Update Date
25 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372229481101
Graduation Year
2007 (19 years ago)
PAC ID
3375625320
Group Practice PAC ID
7618948423
Professional Enrollment ID
I20080129000682
Address ID
OH454391521MO2211XBLVD300

Contacts

Secure Messaging
pvaughan552279@direct.ketteringhealth.org
FHIR Endpoint
https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness85
Years active:18State licenses:2Other namesUpdated within 12 months

14,984 NURSE PRACTITIONER in OH

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Provider Addresses for POLLY S VAUGHAN (CRNP)

  • 6100 GURNEYVILLE RD

    WILMINGTON, OH 451776508

    Phone: (937) 313-4400

    Fax: (937) 488-1414

    Type: Mailing

  • 2, Eaton Avenue, Main Street Historic District, Rossville Historic District, Hamilton, Butler County, Ohio, 45013, United States

    HAMILTON, OH 45013

    Phone: (513) 867-2433

    Fax: (513) 867-2499

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $534.

Total Amount is formed as General ($534) + Research ($0) + Ownership ($0) = $534.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($350).

Total Amount

$534

General + Research + Ownership

Payments

21

Total payment records

General Amount

$534

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

Latest reported date

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: 2008-01-29

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
I20080129000682INurse PractitionerOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes19795$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes125113$0
View full utilization report →

Insurance plans in this area (ZIP 45177)

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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: 7618948423View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

What NPI should I save for POLLY S VAUGHAN (CRNP)?
Save NPI 1063609287 if you need a stable reference for POLLY S VAUGHAN (CRNP).
Is POLLY S VAUGHAN (CRNP) active in the national directory?
POLLY S VAUGHAN (CRNP)'s public NPI profile is in an active state.
Can you summarize POLLY S VAUGHAN (CRNP)'s specialty in plain language?
Clinically, the directory lists POLLY S VAUGHAN (CRNP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place POLLY S VAUGHAN (CRNP)?
The snapshot lists Wilmington, Ohio for POLLY S VAUGHAN (CRNP); download NPPES for the complete set.
Is POLLY S VAUGHAN (CRNP) a real provider?
This page reflects official NPPES data for NPI 1063609287. Always confirm identity and privileges with the practice and licensing boards.

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