Individual provider Active NPI

Tina Jean Hayes, CNM

  • Advanced Practice Midwife
  • Charlotte, NC
National Provider Identifier
1427080357
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
118410 Issued in NC
Practice address
5933 Blakeney Park Dr
Suite 100
Charlotte, NC 28277-5713
Phone
(704) 316-2021
Fax
(704) 316-2025
NPI assigned
Jul 7, 2006
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 118410 NC Primary

Addresses

Primary practice location

5933 Blakeney Park Dr
Suite 100
Charlotte, NC 28277-5713

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-2021

Other identifiers 2

IdentifierTypeStateIssuer
MW0187MedicaidSC
7002160MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thayes427005@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000347 NC Practitioner - Certified Nurse Midwife (CNM) 7911037700 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3427SCMDProfessional Counselor
118410NCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Mar 13, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 3, 2017 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 3, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

15825 Ballantyne Medical Pl
Ste 200
Charlotte, NC 28277
Phone (704) 384-1925

1718 E 4th St
Ste 201
Charlotte, NC 28204
Phone (704) 384-0560

1918 Randolph Rd
Ste 670
Charlotte, NC 28207
Phone (704) 334-9535

5933 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-2021

269 Gillman Rd
Ste 100
Denver, NC 28037
Phone (704) 316-4930

14330 Oakhill Park Ln
Ste 100
Huntersville, NC 28078

911 W Henderson St
Ste 300
Salisbury, NC 28144
Phone (704) 636-9270

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: thayes427005@direct.novanthealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1427080357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-2021",
            "fax_number": "704-316-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 BLAKENEY PARK DR",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282775713",
            "telephone_number": "704-316-2021",
            "fax_number": "704-316-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "TINA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "118410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MW0187",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002160",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thayes427005@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5933 Blakeney Park Dr",
            "address_2": "Suite 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282775713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.