Individual provider Active NPI

Melissa Haines, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairfield, CA
National Provider Identifier
1124689468
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11007464 Issued in FL
Practice address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone
(707) 423-3719
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9294337 FL
Certified Registered Nurse Anesthetist 367500000X 11007464 FL Primary

Addresses

Primary practice location

101 Bodin Cir
Fairfield, CA 94535-1809

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL N/A
Other URL NA
Other URL Na

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118003781 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719356393 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Baptist LLCGroup PAC ID 6901099688, 80 clinicians

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-8478

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9294337FLMDRegistered Nurse
11007464FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 29, 2024 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince May 4, 2024 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2025 Accepting new patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 12, 2023 Accepting new patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2025 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4413 US Highway 331 S
Defuniak Springs, FL 32435
Phone (850) 892-5171

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

1034 Mar Walt Dr
Unit 300
Ft Walton Bch, FL 32547
Phone (850) 315-9363

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1124689468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "MELISSA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9294337",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11007464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "101 Bodin Cir",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945351809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "101 Bodin Cir",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945351809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Na",
            "affiliation": "N",
            "address_1": "101 Bodin Cir",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945351809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.