Jennifer B Haynes, F.N.P

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4031 Issued in SC

Practice address

3236 Holmestown Rd
Suite E1
Myrtle Beach, SC 29588-7495

Phone

(843) 663-8000

NPI assigned

Apr 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Jennifer Butler Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Community Health CareGroup PAC ID 8628227667, shared by 3 NPIs, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.haynes.1@30137.direct.athenahealth.com
• Direct secure messaging: jennifer.haynes@lrmc.directbygreenway.com
• FHIR API: https://api.platform.athenahealth.com/fhir/r4

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.

• Foothills Community Health Care, Inc

  dba Foothills Community Healthcare-Anderson

  • Federally Qualified Health Center (FQHC)
  • Anderson, SC
  • NPI 1063056661
  Medicare reassignment NPD
• Foothills Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Clemson, SC
  • NPI 1538417951
  Medicare reassignment NPD
• Foothills Community Health Care, Inc.

  dba Foothills Community Health Care Easley

  • Federally Qualified Health Center (FQHC)
  • Easley, SC
  • NPI 1083169213
  Medicare reassignment NPD
• Little River Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Little River, SC
  • NPI 1629021076

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1346638483
  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1184783284

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1508120619
  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Loris, SC
  • NPI 1619100096

  Family

  Medicare reassignment NPD
• Little River Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Myrtle Beach, SC
  • NPI 1669535225
  Medicare reassignment
• Foothills Community Health Care, Inc.

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1972369643
  NPD
• Foothills Community Health Care, Inc.

  dba Foothills Community Health Care Inc Mobile

  • Clinic/Center
  • Easley, SC
  • NPI 1861168155
  NPD (past)
• Larry R. Hart, M.D., L.L.C.

  • General Practice Physician
  • Elberton, GA
  • NPI 1790830578
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1235304023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 HOLMESTOWN RD",
            "address_2": "SUITE E1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887495",
            "telephone_number": "843-663-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "credential": "F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN122940",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "4031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC STATE LICENSE",
            "identifier": "4031",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN122940",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004853",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0413",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BUTLER",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Hasty
• Sean Patrick Hatfield
• Dennis Haugen, AA-C
• Nicole Lynn Haunroth, LPC
• Kimberly Ann Hayes
• Robert H Hazelrigg, MD
• Xin Yu He
• Christopher David Headley, BSN, RN
• Jacqueline Michele Headley, BSN RN
• Healing Beach LLC

• Family Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.
• 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.