Individual provider Active NPI

Katherine Haynes, P.A.

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1265823223
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09632 Issued in TX
Practice address
2222 Welborn St
Dallas, TX 75219-3924
Phone
(214) 559-5000
Fax
(214) 443-7309
NPI assigned
Feb 12, 2015
Last updated
Sep 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X PA09632 TX Primary

Addresses

Primary practice location

2222 Welborn St
Dallas, TX 75219-3924

Mailing address

2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150605000078 TX Practitioner - Physician Assistant 5092036806 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09632TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
Texas Scottish Rite Hospital for Crippled Children CurrentSince Apr 11, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

1935 Medical District Dr
Unit A
Dallas, TX 75235

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone 4698572222 ext. 72222

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: katherine.haynes.1@17984.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1265823223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KATHERINE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.