Individual provider Active NPI

Cheryl Haynes, NP

  • Adult Health Nurse Practitioner
  • Warwick, RI
National Provider Identifier
1235284431
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NPP37125 Issued in RI
Practice address
2756 Post Rd
Suite 103
Warwick, RI 02886-3003
Phone
(401) 384-6007
Fax
(401) 773-7878
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN32050 RI
Nurse Practitioner 363L00000X NP37125 RI
Adult Health Nurse Practitioner 363LA2200X NPP37125 RI Primary

Addresses

Primary practice location

2756 Post Rd
Suite 103
Warwick, RI 02886-3003

Mailing address

4 Archer Way
Coventry, RI 02816-4665
Phone (401) 241-3324

Other identifiers 2

IdentifierTypeStateIssuer
0000029629OtherRIRI BLUE CROSS PROVIDER #
412667OtherRIRI BLUE CHIP PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20050827000229 RI Practitioner - Nurse Practitioner 1951332170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN32050RIMDPsychiatric/Mental Health Registered Nurse
NP37125RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Behavioral Health CurrentSince Apr 23, 2023 Accepting new patients

Locations

75 Lambert Lind Hwy
Warwick, RI 02886
Phone (401) 463-5778

75 Lambert Lind Hwy
Ste 120100
Warwick, RI 02886
Phone (401) 681-4274

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1235284431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ARCHER WAY",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028164665",
            "telephone_number": "401-241-3324",
            "fax_number": "401-773-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2756 POST RD",
            "address_2": "SUITE 103",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028863003",
            "telephone_number": "401-384-6007",
            "fax_number": "401-773-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CHERYL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "RI",
            "license": "RN32050",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NP37125",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "NPP37125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS PROVIDER #",
            "identifier": "0000029629",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP PROVIDER #",
            "identifier": "412667",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.