Active NPI
Kelley D Haynes, HIS
- Hearing Instrument Specialist
- Abingdon, VA
National Provider Identifier
1124578711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 2101001707
- Practice address
- 319 Falls Dr NW
Abingdon, VA 24210-8093 - Phone
- (276) 676-1111
- Fax
- (276) 676-1112
- NPI assigned
- Oct 7, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 2101001707 | VA | Primary |
Addresses
Primary practice location
319 Falls Dr NW
Abingdon, VA 24210-8093
Mailing address
319 Falls Dr
Abingdon, VA 24210
Phone (276) 676-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2101001707 | Other | VA | DISPENSING LICENSES |
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 |
|---|---|---|---|
| 2101001707 | VA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1124578711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 FALLS DR",
"city": "ABINGDON",
"state": "VA",
"postal_code": "24210",
"telephone_number": "276-676-1111",
"fax_number": "276-676-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 FALLS DR NW",
"city": "ABINGDON",
"state": "VA",
"postal_code": "242108093",
"telephone_number": "276-676-1111",
"fax_number": "276-676-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "KELLEY",
"middle_name": "D",
"name_prefix": "Miss",
"credential": "HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-07",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "VA",
"license": "2101001707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DISPENSING LICENSES",
"identifier": "2101001707",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.