Individual provider Active NPI

Wanda Marie Haynes, FNP-C

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1235329764
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019040422 Issued in MO
Practice address
9411 N Oak Trfy Ste 205
Kansas City, MO 64155-2229
Phone
(816) 691-3546
Fax
(816) 346-7474
NPI assigned
Jul 31, 2007
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111047 NE
Family Nurse Practitioner 363LF0000X 726951 TX
Family Nurse Practitioner 363LF0000X AP07135 LA
Family Nurse Practitioner 363LF0000X A-123907 IA
Family Nurse Practitioner 363LF0000X 2019040422 MO Primary

Addresses

Primary practice location

9411 N Oak Trfy Ste 205
Kansas City, MO 64155-2229

Mailing address

9411 N Oak Trfy Ste LL1
Kansas City, MO 64155-2262
Phone (816) 691-1655

Other identifiers 1

IdentifierTypeStateIssuer
47428OtherNEBCBS NE

Other names 1

  • Wanda Marie Haynes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wanda.haynes@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200520002819 MO Practitioner - Nurse Practitioner 6507901311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

9411 N Oak Trfy
Suite 205
Kansas City, MO 64155-2229
Phone (816) 691-3546

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123907IAMDHearing Instrument Specialist
A-123907IAMDFamily Nurse Practitioner
726951TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation CurrentSince Nov 11, 2023 Accepting new patients
Meritas Health Corporation CurrentSince Nov 11, 2023 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Planned Parenthood of the Heartland, Inc Past Accepting new patients
C H Wilkinson Physician Network Past Accepting new patients
Pine Lake Health LLC Past Accepting new patients
Meritas Health Corporation Past Accepting new patients
Pine Lake Health LLC Past Accepting new patients

Locations

9411 N Oak Trfy
Ste 100
Kansas City, MO 64155
Phone (816) 436-1800

9411 N Oak Trfy
Ste 205
Kansas City, MO 64155
Phone (816) 691-3546

9411 N Oak Trfy
Ste 260
Kansas City, MO 64155
Phone (816) 453-4000

9411 N Oak Trfy
Ste LL1
Kansas City, MO 64155
Phone (816) 436-7072

Interoperability endpoints

  • Direct secure messaging: wanda.haynes@centerwell.eclinicaldirectplus.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1235329764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY STE LL1",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552262",
            "telephone_number": "816-691-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY STE 205",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552229",
            "telephone_number": "816-691-3546",
            "fax_number": "816-346-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "WANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111047",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "726951",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07135",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-123907",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019040422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE",
            "identifier": "47428",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wanda.haynes@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "301 E Armour Blvd Ste 2East",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641111245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "HAYNES",
            "middle_name": "MARIE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.