Individual provider Active NPI

Christy Haynes, FNP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1336568005
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18618 Issued in TN
Practice address
501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone
(865) 331-2020
Fax
(865) 331-1976
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18618 TN Primary

Addresses

Primary practice location

501 19TH St Ste 401
Knoxville, TN 37916-1831

Mailing address

501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone (865) 331-2020

Other identifiers 1

IdentifierTypeStateIssuer
Q016248MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20211218000089 TN Practitioner - Nurse Practitioner 7113216235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Perinatal Center CurrentSince Jan 1, 2022 Accepting new patients

Locations

501 19th St
Ste 401
Knoxville, TN 37916
Phone (865) 331-2020

Dept 888247
Knoxville, TN 37995

Organizations & group practices 1

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1336568005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020",
            "fax_number": "865-331-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020",
            "fax_number": "865-331-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CHRISTY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016248",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.