Individual provider Active NPI

Linda G Haynes, PNP

  • Pediatric Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1023162476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
164115 Issued in MA
Practice address
85 Herrick St
The Lynch Building
Beverly, MA 01915-1790
Phone
(978) 921-2899
Fax
(978) 921-2968
NPI assigned
Jan 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 164115 MA Primary

Addresses

Primary practice location

85 Herrick St
The Lynch Building
Beverly, MA 01915-1790

Mailing address

14 Pinehurst Dr
Boxford, MA 01921-2418
Phone (978) 273-0761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150105000899 MA Order and Referring Only - Nurse Practitioner 9436472107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
164115MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Boston Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lhaynes25805@direct.bostonchildrens.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023162476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PINEHURST DR",
            "city": "BOXFORD",
            "state": "MA",
            "postal_code": "019212418",
            "telephone_number": "978-273-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "THE LYNCH BUILDING",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-921-2899",
            "fax_number": "978-921-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "LINDA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "164115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.