NPIMap

Individual provider Active NPI

Elizabeth Miles Haynes, PA-C

  • Medical Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1083934343
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-02327 Issued in NC
Practice address
1010 Bethesda CT
Winston Salem, NC 27103-3019
Phone
(336) 277-8800
Fax
(336) 277-8850
NPI assigned
Jun 9, 2010
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02327 NC
Medical Physician Assistant 363AM0700X 0010-02327 NC Primary

Addresses

Primary practice location

1010 Bethesda CT
Winston Salem, NC 27103-3019

Mailing address

PO Box 75216
Charlotte, NC 28275-0216
Phone (336) 718-7080

Other practice location 1

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-8386

Other identifiers 1

IdentifierTypeStateIssuer
8101963MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehaynes141740@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100623000310 NC Practitioner - Physician Assistant 4587795307 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-8386

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1717

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 718-7080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Jun 25, 2022 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Mar 1, 2022 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Jun 25, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Piedmont Hematology-Oncology Associates, PLLC Medical Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 175
Charlotte, NC 28207
Phone (704) 316-1050

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: ehaynes141740@direct.novanthealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1083934343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282750216",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BETHESDA CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033019",
            "telephone_number": "336-277-8800",
            "fax_number": "336-277-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 S Hawthorne Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033912",
            "country_code": "US",
            "telephone_number": "336-718-8386",
            "fax_number": "336-718-0290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ELIZABETH",
        "middle_name": "MILES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02327",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101963",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehaynes141740@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1010 Bethesda Ct",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.