Individual provider Active NPI

Sheldon Haynes, MD (DHM)

  • Neurology Physician
  • Topeka, KS
National Provider Identifier
1083490502
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
KS04-64104 Issued in KS
Practice address
5119 NW Kendall CT
Topeka, KS 66618-1269
Phone
(785) 817-1893
Fax
(785) 578-0009
NPI assigned
Sep 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X KS-ASCX12N KS
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X KS04-64104 KS Primary

Addresses

Primary practice location

5119 NW Kendall CT
Topeka, KS 66618-1269

Mailing address

5119 NW Kendall CT
Topeka, KS 66618-1269
Phone (785) 817-1893

Other identifiers 6

IdentifierTypeStateIssuer
C23124507MedicaidKS
7495262273OtherKSSTATE LICENSE NO.
BH5617545MedicaidKS
G23123897MedicaidKS
W23124507CMedicaidKS
KS04-64104OtherKSLICENCE NUMBER

Other names 1

  • Dequan' Dr Dequan Professional name

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
KS-ASCX12NKSMDFamily Medicine Physician
KS04-64104KSMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimistic Wellness LLC Multi-Specialty CurrentSince Nov 12, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1083490502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 NW KENDALL CT",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666181269",
            "telephone_number": "785-817-1893",
            "fax_number": "785-578-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5119 NW KENDALL CT",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666181269",
            "telephone_number": "785-817-1893",
            "fax_number": "785-578-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "SHELDON",
        "name_prefix": "Dr.",
        "credential": "MD (DHM)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-01",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "KS-ASCX12N",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KS",
            "license": "KS04-64104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C23124507",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NO.",
            "identifier": "7495262273",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH5617545",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G23123897",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W23124507C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "KS04-64104",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEQUAN'",
            "last_name": "DEQUAN",
            "middle_name": "DR",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.