Kevin Anderson Haynes, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

021363 Issued in NY

Practice address

1775 Grand Concourse
Bronx, NY 10453

Phone

(718) 579-3941

NPI assigned

Jan 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1295242576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "718-579-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-579-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 pond way",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10303",
            "country_code": "US",
            "telephone_number": "917-572-9702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 pond way",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10303",
            "country_code": "US",
            "telephone_number": "917-572-9702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 pond way",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10303",
            "country_code": "US",
            "telephone_number": "917-572-9702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KEVIN",
        "middle_name": "ANDERSON",
        "name_prefix": "Mr.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley'S Comet LLC
• Daniella Riva Haymof
• Tricia Haynes-Holder
• Hilda A Haynes-Lewis, RNP
• Barbara Annette Haynes, PH.D
• Paula Elizabeth Haynes, LMSW
• Shaneek Haynes
• Sonia Haynes, LCSW
• Tiara Haynes
• Tracy Elizabeth Haynes, MSW

• Occupational Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.