Active NPI
Paul B. Haynes, M.D.
- Family Medicine Physician
- Rathdrum, ID
National Provider Identifier
1245241561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D0018883
- Practice address
- 16760 N Highway 41
Rathdrum, ID 83858-8715 - Phone
- (208) 687-9113
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D0018883 | MD | Primary |
Addresses
Primary practice location
16760 N Highway 41
Rathdrum, ID 83858-8715
Mailing address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406995100 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0018883 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kochmann Collector, P.a. | Past | Accepting new patients | |
| Emergency Physicians PC | Past | Accepting new patients | |
| Emcare Physician Providers, Inc | Past | Accepting new patients | |
| Emcare Physician Providers, Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Copperhill, TN
- NPI 1992756787
-
- Emergency Medicine Physician
- Morristown, TN
- NPI 1598714826
-
- Emergency Medicine Physician
- Chattanooga, TN
- NPI 1912955360
-
- Primary Care Clinic/Center
- Timonium, MD
- NPI 1912917980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1245241561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 KOOTENAI HEALTH WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838146051",
"telephone_number": "208-625-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16760 N HIGHWAY 41",
"city": "RATHDRUM",
"state": "ID",
"postal_code": "838588715",
"telephone_number": "208-687-9113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "PAUL",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0018883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "406995100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rathdrum, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.