Matthew Haynes

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

1981 Issued in MS

Practice address

4270 Robinson St
Jackson, MS 39209-6517

Phone

(601) 383-4747

NPI assigned

Oct 23, 2023

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Skyz Still Waters

  • Massage Therapist
  • Jackson, MS
  • NPI 1760238869
  NPD Authorized official

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1366214579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 WINGFIELD CIR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097129",
            "telephone_number": "601-383-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 ROBINSON ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392096517",
            "telephone_number": "601-383-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MS",
            "license": "1981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronesha Haygood, ADMINISTRATOR/ OWNER
• Candice Haymer, LCSW
• Avis Elaine Haynes, PHD RN CNM FPNP
• Demondes Haynes, M.D.
• Joanne Haynes, NP
• Renee Haynes
• Virginia Turner Haynes, CCC-SLP
• Lisa Haynie, CFNP
• Alesia Hays, LPC
• James Clay Hays Sr., MD

• Massage Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Massage Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.