Jackson Haynes, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E15843 Issued in AR

Practice address

1601 W 40TH Ave Ste 100
Pine Bluff, AR 71603-6069

Phone

(870) 541-6000

Fax

(870) 541-6009

NPI assigned

Mar 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Arkansas Emergency Physicians LLPGroup PAC ID 6204146319, 17 clinicians

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
• National Park Medical Center Hospital, Hot Springs, AR, CCN 040078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1922475078
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment Care Compare group NPD
• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630
  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305
  Medicare reassignment NPD
• Ess of Fordyce LLC

  • Emergency Medicine Physician
  • Fordyce, AR
  • NPI 1821547977
  Medicare reassignment NPD
• Ess of McGehee LLC

  • Emergency Medicine Physician
  • MC Gehee, AR
  • NPI 1639822653
  Medicare reassignment NPD
• Hospital Care Consultants of Fordyce LLC

  • Hospitalist Physician
  • Fordyce, AR
  • NPI 1316497464
  Medicare reassignment NPD
• HCC of Warren Hospitalist LLC

  • Emergency Medicine Physician
  • Warren, AR
  • NPI 1326641606
  NPD
• HCC of Warren LLC

  • Hospitalist Physician
  • Warren, AR
  • NPI 1952904237
  NPD
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1467817411
  NPD
• Family Practice Associates of Clarksville,PA

  • Legal Medicine
  • Clarksville, AR
  • NPI 1518957240
  NPD (past)

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

• Hot Springs National Park Hospital Holdings LLC

  • General Acute Care Hospital
  • Hot Springs, AR
  • NPI 1841241833
  Care Compare affiliation
• Jefferson Hospital Association Inc

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1255918157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6000",
            "fax_number": "870-541-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6000",
            "fax_number": "870-541-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E15843",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E15843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Harrison
• Elizabeth Hartz, DNP, APRN, FNP-BC
• Khaled Hassan, MD
• Kai Charmeen Hawkins
• Rae-Shem Hawkins, B.S
• Hazel Street Nursing Association
• Annabeth Monet Hazlewood, APN
• Healing Circle Relationship Wellness Center LLC
• Healthwise Wellness Direct PLLC
• Healthwise Wellness LLC

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.