Individual provider Active NPI

Lauren Haynes

  • Registered Dietitian
  • Jacksonville, FL
National Provider Identifier
1295548188
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
13835 Issued in FL
Practice address
4203 Belfort Rd
Jacksonville, FL 32216-1409
Phone
(904) 450-6090
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 13835 FL Primary

Addresses

Primary practice location

4203 Belfort Rd
Jacksonville, FL 32216-1409

Mailing address

216 Yarbrough Rd
St Augustine, FL 32095-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250206003426 FL Practitioner - Registered Dietitian Or Nutrition Professional 4688104573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

4205 Belfort Rd
Suite 3075
Jacksonville, FL 32216-1475
Phone (904) 308-7790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13835FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Feb 3, 2025 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Feb 3, 2025 Accepting new patients

Locations

4203 Belfort Rd
Jacksonville, FL 32216
Phone (904) 296-3711

2 Shircliff Way
Ste 535
Jacksonville, FL 32204

4205 Belfort Rd
Ste 4030
Jacksonville, FL 32216
Phone (904) 450-6090

Interoperability endpoints

  • Direct secure messaging: lauren.haynes.1@8967.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1295548188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 YARBROUGH RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161409",
            "telephone_number": "904-450-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "13835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.