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

Kyle Vaughn, PA-C

Individual provider Medical Physician Assistant · NPI 1841739141

Kyle Vaughn, PA-C is a Physician Assistant in Norfolk, Virginia. Qualified in 2016, 10 years ago. Practices with Tidewater Kidney Specialists Inc, a 21-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina and Virginia.

Years since qualifying
10
Licensed in
NC, VA
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

814 Kempsville Rd Ste 102
Norfolk, VA 23502-4001
Phone: (757) 623-0005
Fax: (757) 389-5412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 0110007161 (VA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 0010-07079 (NC)

Record details

NPI number1841739141
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 20, 2017
Last updated in NPPESJanuary 20, 2022
Certification dateJanuary 20, 2022
Mailing address4445 Corporation Ln Ste 100, Virginia Beach, VA 23462-3666

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Tidewater Kidney Specialists Inc — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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