Active NPI
Marjorie Prim Haynes, PT,DPT, MA, PCS
- Pediatric Physical Therapist
- Rockingham, NC
National Provider Identifier
1437286325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 847
- Practice address
- 207 Fairway Dr
Rockingham, NC 28379-9414 - Phone
- (910) 895-7850
- Fax
- (910) 895-7850
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 847 | NC | Primary |
Addresses
Primary practice location
207 Fairway Dr
Rockingham, NC 28379-9414
Mailing address
207 Fairway Dr
Rockingham, NC 28379-9414
Phone (910) 895-7850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7212694 | Medicaid | NC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 847 | NC | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275350400000",
"number": "1437286325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 FAIRWAY DR",
"city": "ROCKINGHAM",
"state": "NC",
"postal_code": "283799414",
"telephone_number": "910-895-7850",
"fax_number": "910-895-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 FAIRWAY DR",
"city": "ROCKINGHAM",
"state": "NC",
"postal_code": "283799414",
"telephone_number": "910-895-7850",
"fax_number": "910-895-7850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "MARJORIE",
"middle_name": "PRIM",
"credential": "PT,DPT, MA, PCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2010-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7212694",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockingham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.