TOM BROOKS VAUGHAN JR. (NPI# 1518026319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518026319 |
| Entity Type | Individual |
| Full Name | TOM BROOKS VAUGHAN JR. |
| Credential | MD |
| Practice Address |
2204 Lakeshore Dr Suite 410 Birmingham AL 35209-6729 |
| Practice Telephone | 2058705678 |
| Practice Fax Number | 2058790071 |
| Mailing Telephone | 2058705678 |
| Mailing Fax Number | 2058790071 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2013-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD.6420 | AL | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
6420 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000024822 | 05 | |
| AL | BCBS | 510-82996 | 01 |
| AL | FEDERAL BC | 515-02331 | 01 |
| AL | BCBS | 510-24822 | 01 |
| AL | 000082996 | 05 | |
| AL | TRICARE SOUTH | 1518026319 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720021736 | Tom Brooks Vaughan IIi | Internal Medicine | 619 19th Street South, Birmingham, AL 35233 | 2006-06-14 |
| Street Address |
2204 LAKESHORE DR SUITE 410 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-6729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760977623 | Heather Forbes | Counselor | 2204 Lakeshore Dr, Birmingham, AL 35209-6729 | 2018-06-24 |
| 1013469337 | Kent S. Michael | Marriage & Family Therapist | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2016-11-03 |
| 1366837122 | Heather Hagins | Counselor | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2015-03-30 |
| 1417381534 | Lisa Dawn Phillips | Counselor | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2013-08-26 |
| 1508124835 | Frederick Lee Kracke Jr. | Counselor | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2012-04-24 |
| 1073888145 | Dan E Harris | Nurse Practitioner | 2204 Lakeshore Dr, Suite 440, Birmingham, AL 35209-6729 | 2012-03-21 |
| 1548537509 | Covenant Counseling and Education Center | Community/Behavioral Health | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2011-11-18 |
| 1487951976 | Natalie Lane Walthall Beatty | Marriage & Family Therapist | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2011-02-17 |
| 1508187394 | Kara K Jones | Counselor | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2010-06-16 |
| 1730400532 | Emory Langston Haygood | Counselor | 2204 Lakeshore Dr, Suite 212, Birmingham, AL 35209-6729 | 2010-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063688216 | Central Alabama Psychiatry, LLC | Psychiatry & Neurology | 2100a Southbridge Pkwy, Suite 540, Birmingham, AL 35209-1370 | 2008-05-07 |
| 1134222094 | Child & Adolescent Associates P.C. | Psychiatry & Neurology | 1025 Montgomery Hwy., Suite 200, Birmingham, AL 35216-2803 | 2006-09-06 |
| 1548236458 | Helen Teresa Moran | Psychiatry & Neurology | 1025 Montgomery Hwy, Suite 200, Birmingham, AL 35216-2845 | 2006-02-28 |
| 1598263410 | Shelley Lauterbach | Psychiatry & Neurology | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2018-01-25 |
| 1902247323 | Blessing Nnenna Falola | Psychiatry & Neurology | 625 19th St S, Birmingham, AL 35233-1900 | 2013-07-14 |
| 1194160614 | Elizabeth Ferguson | Psychiatry & Neurology | 601 Beacon Pkwy W Ste 201, Birmingham, AL 35209-3123 | 2013-05-10 |
| 1437435591 | Shehi Medical, LLC | Psychiatry & Neurology | 2100a Southbridge Pkwy, Birmingham, AL 35209-1370 | 2011-11-02 |
| 1518257575 | Jesse Carrillo Martinez Jr. | Psychiatry & Neurology | 619 19th St S, Birmingham, AL 35249-1900 | 2011-04-12 |
| 1679863690 | Yesie Yoon | Psychiatry & Neurology | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2011-04-11 |
| 1366731168 | Janaki Nimmagadda | Psychiatry & Neurology | 1600 7th Ave S, Ireland Center, Birmingham, AL 35233-1711 | 2011-04-01 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35209 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.