NPIMap

Organization Active NPI

Grace a Haynes PC

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1316116841
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRACE A HAYNES PC
Practice address
4824 E Baseline Rd Ste 140
Mesa, AZ 85206
Phone
(480) 505-3276
Fax
(480) 545-9594
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Authorized official

Name
Dr. Grace Andrea Haynes, MDNPI 1215070792
Title
President
Phone
(480) 505-3276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4824 E Baseline Rd Ste 140
Mesa, AZ 85206

Mailing address

4824 E Baseline Rd Ste 140
Mesa, AZ 85206-4680
Phone (480) 969-4040

Other identifiers 1

IdentifierTypeStateIssuer
199895MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1501 N Gilbert Rd
Ste 130
Gilbert, AZ 85234
Phone (480) 505-3276

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1316116841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD STE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064680",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD STE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-505-3276",
            "fax_number": "480-545-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE A HAYNES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-505-3276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199895",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.