Kenneth Ray Haynes, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0116039791 Issued in VA

Practice address

109 Bridge St
Ste 201
Danville, VA 24541

Phone

(434) 799-4488

Fax

(434) 773-6977

NPI assigned

Apr 30, 2024

Last updated

Jun 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kenneth.haynes.1@19847.direct.athenahealth.com

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1396592127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST",
            "address_2": "STE 201",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "24541",
            "telephone_number": "434-799-4488",
            "fax_number": "434-773-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST",
            "address_2": "STE 201",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "24541",
            "telephone_number": "434-799-4488",
            "fax_number": "434-773-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KENNETH",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116039791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Hayes, LPC
• Lydia Faith Hayes, MS
• Ray H Hayes II, PT
• Amy Haymore
• Christi Lee Haynes, OTR LICENSED
• Bridget Hazelwood, PT DPT
• Healing Touch Therapy Inc
• Healthstat Onsite Clinic Goodyear-Danville
• Heart of Hands Home Care Services, LLC
• Hearts of Care Home Services

• Family Medicine Physician in Danville, VA
• Providers in Danville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.