Active NPI
William B Haynes Jr., MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Johns Creek, GA
National Provider Identifier
1063436103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 35897
- Practice address
- 6335 Hospital Pkwy Ste 302
Johns Creek, GA 30097-5712 - Phone
- (678) 513-8111
- Fax
- (678) 990-1956
- NPI assigned
- Jul 26, 2006
- Last updated
- Nov 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 35897 | GA | Primary |
Addresses
Primary practice location
6335 Hospital Pkwy Ste 302
Johns Creek, GA 30097-5712
Mailing address
2065 Southers Cir
Suwanee, GA 30024-5487
Phone (678) 513-8111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35897 | GA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haynes Sports Medicine | Sports Medicine | Past | Accepting new patients |
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": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511222400000",
"number": "1063436103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2065 SOUTHERS CIR",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300245487",
"telephone_number": "678-513-8111",
"fax_number": "678-990-1956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6335 HOSPITAL PKWY STE 302",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300975712",
"telephone_number": "678-513-8111",
"fax_number": "678-990-1956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "WILLIAM",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2017-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "GA",
"license": "35897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.