Hienok Hailu

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2016015067 Issued in MO

Practice address

11725 Casa Grande Dr
Saint Louis, MO 63146-4223

Phone

(314) 255-8395

NPI assigned

Aug 22, 2016

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1144775966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11725 CASA GRANDE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464223",
            "telephone_number": "314-255-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 CASA GRANDE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464223",
            "telephone_number": "314-255-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILU",
        "first_name": "HIENOK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016015067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imran Haider, M.D.
• Kristen Maire Haider, AU.D.
• Atef Haifa, DO
• Katrina Mae Haigh, NP, CPNP-PC
• Hailand Dental LLC
• Roman Hailu, FNP
• Emily Grace Haines, MD
• Erica Diane Haines, M.A., CCC/SLP
• Hannah M Haines, AA
• William F Haines, DMD

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.