DOMINIQUE NICOLE VAUGHN (AGNP-C) – Gerontology Nurse Practitioner, NPI 1124884895
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,656 NURSE PRACTITIONER in TN
Provider Addresses for DOMINIQUE NICOLE VAUGHN (AGNP-C)
682 WOODLAND FOX LN W
CORDOVA, TN 380181147
Phone:
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $161.
Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($99).
Total Amount
$161
General + Research + Ownership
Payments
8
Total payment records
General Amount
$161
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $99 |
| Novo Nordisk Inc | $45 |
| E.R. Squibb & Sons, L.L.C. | $17 |
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: 2024-03-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240312003263 | I | Nurse Practitioner | TN | TBD |
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.
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 38018)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Emergency Medicine | MI | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Physician Assistant | MI | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | NC | |
| Nurse Practitioner | MO |
Reviews
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