Active NPI
Clara Elane Haynes, OTR/L
- Occupational Therapist
- Martinsville, VA
National Provider Identifier
1336865781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119009485
- Practice address
- 350 Kings Way Rd
Martinsville, VA 24112-6631 - Phone
- (276) 634-1000
- NPI assigned
- Oct 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119009485 | NC | Primary |
Addresses
Primary practice location
350 Kings Way Rd
Martinsville, VA 24112-6631
Mailing address
771 Yount Rd
Eden, NC 27288-8239
Phone (336) 552-3714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119009485 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1336865781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 YOUNT RD",
"city": "EDEN",
"state": "NC",
"postal_code": "272888239",
"telephone_number": "336-552-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 KINGS WAY RD",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241126631",
"telephone_number": "276-634-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "CLARA",
"middle_name": "ELANE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-18",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "0119009485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.