Active NPI
Jimmie C Haynes, RPH
- Pharmacist
- Houston, TX
National Provider Identifier
1194943258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 01676
- Practice address
- 8109 Cullen Blvd
Ste B
Houston, TX 77051-2064 - Phone
- (713) 733-7424
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 01676 | TX | Primary |
Addresses
Primary practice location
8109 Cullen Blvd
Ste B
Houston, TX 77051-2064
Mailing address
8109 Cullen Blvd
Ste B
Houston, TX 77051-2064
Phone (713) 733-7424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120244 | Medicaid | TX |
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01676 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nikki'S Apothecary, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Houston, TX
- NPI 1851501316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194943258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8109 CULLEN BLVD",
"address_2": "STE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770512064",
"telephone_number": "713-733-7424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8109 CULLEN BLVD",
"address_2": "STE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770512064",
"telephone_number": "713-733-7424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "JIMMIE",
"middle_name": "C",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "01676",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120244",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.