NPIMap

Organization Active NPI

Doctor Amy Haynes Inc

  • Naturopath
  • Missoula, MT
National Provider Identifier
1336745652
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
Legal business name
DOCTOR AMY HAYNES INC
Practice address
521 S 2ND St W
Missoula, MT 59801-1832
Phone
(406) 721-2147
Fax
(406) 543-1020
NPI assigned
Dec 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Stephanie Raven, NDNPI 1871061630
Title
Naturopathic Doctor
Phone
(406) 721-2147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193400000X SINGLE SPECIALTY GROUP 175F00000X Primary

Addresses

Primary practice location

521 S 2ND St W
Missoula, MT 59801-1832

Mailing address

521 S 2ND St W
Missoula, MT 59801-1832
Phone (406) 721-2147

Other identifiers 3

IdentifierTypeStateIssuer
1871061630OtherINDIVIDUAL NPI DR. STEPHANIE RAVEN
AHC-NAT-LIC-1945OtherMTSTATE LICENSE DR RAVEN
14923677OtherCAQH DR. RAVEN

Other names 1

  • Full Circle Natural Medical Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@fullcirclemedicalclinic.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1336745652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S 2ND ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011832",
            "telephone_number": "406-721-2147",
            "fax_number": "406-543-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S 2ND ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011832",
            "telephone_number": "406-721-2147",
            "fax_number": "406-543-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR AMY HAYNES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "RAVEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "NATUROPATHIC DOCTOR",
        "authorized_official_telephone_number": "406-721-2147",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI DR. STEPHANIE RAVEN",
            "identifier": "1871061630",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE DR RAVEN",
            "identifier": "AHC-NAT-LIC-1945",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH DR. RAVEN",
            "identifier": "14923677",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@fullcirclemedicalclinic.com",
            "affiliation": "N",
            "endpointDescription": "office email (GSuite)",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "521 S 2nd St W",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598011832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Full Circle Natural Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.