Individual provider Active NPI

Eric W Haynes, CRNA

  • Certified Registered Nurse Anesthetist
  • Rogers, AR
National Provider Identifier
1376077388
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003203 Issued in AR
Practice address
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone
(479) 338-8000
Fax
(479) 338-3056
NPI assigned
Apr 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201034161 MO
Certified Registered Nurse Anesthetist 367500000X C003203 AR Primary

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758-1452

Mailing address

PO Box 507
Lowell, AR 72745-0507
Phone (913) 647-4100

Other identifiers 5

IdentifierTypeStateIssuer
221077001MedicaidAR
P01899051OtherARRAILROAD
1376077338MedicaidMO
5CL80OtherARBCBS ARKANSAS
200788720AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718003222 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163792508 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

2708 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

4301 Willow Creek Dr
Springdale, AR 72762-8711
Phone (870) 261-0188

609 W Maple Ave
Springdale, AR 72764-5335
Phone (479) 757-4001

700 W Grove St
Medical Center of South Arkansas
El Dorado, AR 71730-4416
Phone (870) 863-2000

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
201034161MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 24, 2025 Accepting new patients
Renew Medical Group of Arkansas LTD Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Anesthesia Services of Benton County PA CurrentSince Aug 1, 2017 Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2708 S Rife Medical Ln
Ste 300
Rogers, AR 72758
Phone (479) 338-3030

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1376077388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ERIC",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "201034161",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221077001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01899051",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376077338",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ARKANSAS",
            "identifier": "5CL80",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200788720A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.