Roy G. Haynes, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209-001422 Issued in IL

Practice address

2200 Jacobssen Dr Ste B
Normal, IL 61761-5516

Phone

(309) 451-1123

Fax

(309) 451-1212

NPI assigned

Aug 16, 2006

Last updated

Dec 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• R Garland Haynes Other name

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Pain Services LLCGroup PAC ID 6507930526, 28 clinicians

Premier Medical Group, LLCGroup PAC ID 5991989477, 10 clinicians

Practice addresses (Care Compare)

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 Pain Services LLC

  • Anesthesiology Physician
  • Streator, IL
  • NPI 1790075489
  Medicare reassignment Care Compare group NPD
• Premier Medical Group, LLC

  • Surgery Physician
  • Bloomington, IL
  • NPI 1942501978

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Windy City Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Frankfort, IL
  • NPI 1932248622
  Medicare reassignment
• Great Lakes Anesthesia, P.C.

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1720039977
  Medicare reassignment
• Premier Medical Group, LLC

  dba Drs. Kulb, Chalian and Leak Urology

  • Urology Physician
  • Bloomington, IL
  • NPI 1427357227
  NPD
• Christie Clinic, PLLC

  • Internal Medicine Physician
  • Champaign, IL
  • NPI 1871523829
  NPD (past)
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  NPD (past)
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Specialty Pharmacy

  • Community/Retail Pharmacy
  • Gibson City, IL
  • NPI 1245105535
  NPD (past)
• Granite City Clinic Corp

  dba Granite City Anesthesia

  • Certified Registered Nurse Anesthetist
  • Granite City, IL
  • NPI 1003892464

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)
• Illinois Anesthesia Associates PC

  • Anesthesiology Physician
  • Kankakee, IL
  • NPI 1962459669

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1174636989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ROY",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28163503A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-001422",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-217502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "HAYNES",
            "middle_name": "GARLAND",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Summer Mustafa Hassan, D.O.
• Brooke Hassler
• Dru D. Hauter, M.D.
• Marcia K. Hauter
• Allyson Hawkins, PH.D.
• Candi Hazelwonder, CST
• Heartland of Normal Il LLC (Heartland Health Care Center-Normal)
• Quintin Hecht
• Chris M Heddon, DO
• David William Held, RPH

• Certified Registered Nurse Anesthetist in Normal, IL
• Providers in Normal, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.