Active NPI
Timothy Lorne Haynes, D.C.
- Chiropractor
- Fremont, CA
National Provider Identifier
1093270688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC34285
- Practice address
- 3775 Beacon Ave.
Suite 200
Fremont, CA 94538 - Phone
- (510) 371-5124
- Fax
- (949) 655-7873
- NPI assigned
- Feb 7, 2019
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC34285 | CA | Primary |
Addresses
Primary practice location
3775 Beacon Ave.
Suite 200
Fremont, CA 94538
Mailing address
3775 Beacon Ave.
Suite 200
Fremont, CA 94538
Phone (510) 371-5124
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC34285 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haynes Chiropractic | Chiropractor | Current | Accepting new patients |
| Tim Gudilin Chiropractic Inc | Chiropractor | Past | Accepting new patients |
| Ken Savage Chiropractic, Inc | Chiropractor | Past | Accepting new patients |
Locations
3775 Beacon Ave
Ste 200
Fremont, CA 94538
Phone (501) 371-5124
Organizations & group practices 3
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.
-
- Chiropractor
- Fremont, CA
- NPI 1811595762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607817600000",
"number": "1093270688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 BEACON AVE.",
"address_2": "SUITE 200",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-371-5124",
"fax_number": "949-655-7873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3775 BEACON AVE.",
"address_2": "SUITE 200",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-371-5124",
"fax_number": "949-655-7873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "TIMOTHY",
"middle_name": "LORNE",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-07",
"last_updated": "2020-12-13",
"certification_date": "2020-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC34285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.