Individual provider Active NPI

Gabrielle Haynes, FNP

  • Family Nurse Practitioner
  • Kaufman, TX
National Provider Identifier
1073933784
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
852958 Issued in TX
Practice address
101 N Houston St
Kaufman, TX 75142-1950
Phone
(972) 932-3108
Fax
(972) 932-7007
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 852958 TX Primary

Addresses

Primary practice location

101 N Houston St
Kaufman, TX 75142-1950

Mailing address

PO Box 1908
Greenville, TX 75403-1908
Phone (903) 454-3025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, ME3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140714000355 TX Practitioner - Nurse Practitioner 5597980235 Reassigns benefits to 1 organization
I20150910001361 NM Practitioner - Nurse Practitioner 5597980235 Reassigns benefits to 1 organization
I20210601000593 ME Practitioner - Nurse Practitioner 5597980235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
852958TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pintado Clinic Current Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Thoreau Clinic CurrentSince Mar 28, 2019 Accepting new patients
Presbyterian Medical Services CurrentSince Jun 4, 2024 Accepting new patients
Presbyterian Medical Services CurrentSince Jun 4, 2024 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital CurrentSince Mar 28, 2019 Accepting new patients
Familycare Associates,PA Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1073933784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754031908",
            "telephone_number": "903-454-3025",
            "fax_number": "903-450-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N HOUSTON ST",
            "city": "KAUFMAN",
            "state": "TX",
            "postal_code": "751421950",
            "telephone_number": "972-932-3108",
            "fax_number": "972-932-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "GABRIELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "852958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaufman, TX

Sources for this page

Verify at the official NPI Registry.