Theodore David Haynes Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

549839 Issued in TX

Practice address

1600 11TH St
Dept. Anesthesia
Wichita Falls, TX 76301-4300

Phone

(940) 764-3390

Fax

(940) 764-3391

NPI assigned

Feb 15, 2006

Last updated

Nov 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  CO, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Arapahoe Gastroenterology Anesthesia Associates LLC

  dba Central Colorado Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Littleton, CO
  • NPI 1598115479

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• North Texas Anesthesia Group L.L.P

  • Specialist
  • Wichita Falls, TX
  • NPI 1669505319
  NPD (past)
• North Texas Anesthesia Group L.L.P.

  • Specialist
  • Wichita Falls, TX
  • NPI 1033322383
  NPD (past)
• Broad Anesthesia Associates

  • Anesthesiology Physician
  • Boca Raton, FL
  • NPI 1033136064
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1144294158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 S SHEPHERDS GLN",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763085450",
            "telephone_number": "940-691-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 11TH ST",
            "address_2": "DEPT. ANESTHESIA",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014300",
            "telephone_number": "940-764-3390",
            "fax_number": "940-764-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "THEODORE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "549839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "86602U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hawkeye Open MRI & Imaging Center, LLC
• Hayley Eye Clinic, P.C. (Hayley Eye Clinic)
• Hayley Eye Clinic, P.C.
• Joe C Hayley, O.D.
• Lauren P Hayley, M.D.
• Emily Patrice Hays, PHARM D
• Head & Neck Surgical Associates
• Healing Hands Chirorpactic Center
• Healing Hands Healthcare
• Healing Hands Healthcare LLC

• Certified Registered Nurse Anesthetist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.