Individual provider Active NPI

Gregory Delano Haynes, M.D.

  • Gastroenterology Physician
  • Lenoir, NC
National Provider Identifier
1144330747
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Practice address
401 Mulberry St SW
Suite 206
Lenoir, NC 28645-5463
Phone
(828) 572-1770
Fax
(828) 572-1763
NPI assigned
Aug 30, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NC Primary

Addresses

Primary practice location

401 Mulberry St SW
Suite 206
Lenoir, NC 28645-5463

Mailing address

401 Mulberry St SW
Suite 206
Lenoir, NC 28645-5463
Phone (828) 572-1770

Other identifiers 1

IdentifierTypeStateIssuer
2628362MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-00455NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Anesthesia Associates PA PastSince Mar 15, 2017 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1144330747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MULBERRY ST SW",
            "address_2": "SUITE 206",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455463",
            "telephone_number": "828-572-1770",
            "fax_number": "828-572-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MULBERRY ST SW",
            "address_2": "SUITE 206",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455463",
            "telephone_number": "828-572-1770",
            "fax_number": "828-572-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "GREGORY",
        "middle_name": "DELANO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2628362",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.