Keith Bryan Haynie, DNP, RN, CFNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP01098 Issued in NM

Practice address

206 S Coronado Ave
Espanola, NM 87532-2792

Phone

(860) 788-6404

Fax

(860) 398-6441

NPI assigned

Dec 17, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chrysalis Healthcare LLCGroup PAC ID 6204246580, 10 clinicians

The Gold Standard Mental Health Institute PCGroup PAC ID 6608397435, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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

• Chrysalis Healthcare LLC

  • Psychiatry Physician
  • Albuquerque, NM
  • NPI 1982219499
  Medicare reassignment Care Compare group NPD
• The Gold Standard Mental Health Institute, P.C

  • Marriage & Family Therapist
  • Santa Fe, NM
  • NPI 1992500094
  Medicare reassignment Care Compare group NPD
• Meditelecare of New Mexico, LLC

  • Psychiatry Physician
  • Espanola, NM
  • NPI 1629639729

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1033355284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S CORONADO AVE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322792",
            "telephone_number": "860-788-6404",
            "fax_number": "860-398-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNIE",
        "first_name": "KEITH",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-17",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R45728",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP01098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Scott Harbaugh, DDS
• Fay L Harris, DENTAL HYGIENIST
• William David Harris Jr., PHARMD
• Donald W Hassemer, MD
• Leslie A Hayes, M.D.
• Sharon A Henderson, L.M.T.
• Jaime Hernandez
• Angelic Herrera
• Michael Higbee, CPSW
• Michael Waidner Hill, LISW

• Psychiatric/Mental Health Nurse Practitioner in Espanola, NM
• Providers in Espanola, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.