Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brian Vaughn

Individual provider Certified Registered Nurse Anesthetist · NPI 1477941755

Brian Vaughn is a Certified Registered Nurse Anesthetist (CRNA) in Boise, Idaho. Qualified in 2015, 11 years ago. Practices with St Alphonsus Professional Medical Services LLC, a 123-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Tennessee.

Years since qualifying
11
Licensed in
ID, TN
In the registry since
2015
Specialties on file
3
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Practice location Address checks out

1055 N Curtis Rd
Boise, ID 83706-1309
Phone: (208) 367-5170
Fax: (208) 367-5180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 130 W Ravine Rd, Kingsport, TN 37660-3837 — (423) 224-4000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 59454 (ID)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 19532 (TN)
Registered Nurse Taxonomy 163W00000X · Licence 0000165025 (TN)

Record details

NPI number1477941755
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 8, 2015
Last updated in NPPESSeptember 29, 2023
Certification dateSeptember 29, 2023
Mailing addressPo Box 7411114, Chicago, IL 60674-1114

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice St Alphonsus Professional Medical Services Llc — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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