Active NPI
Chrystie Haynes, O.D.
- Optometrist
- Wellesley, MA
National Provider Identifier
1447430921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3246 AT
- Practice address
- 888 Worcester St
C/O Healthdrive
Wellesley, MA 02482-3717 - Phone
- (617) 964-6681
- NPI assigned
- Nov 13, 2007
- Last updated
- Dec 6, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3246 AT | OR | Primary |
| Optometrist | 152W00000X | 4884 TP | MA | |
| Optometrist | 152W00000X | 007236 | NY |
Addresses
Primary practice location
888 Worcester St
C/O Healthdrive
Wellesley, MA 02482-3717
Mailing address
20615 Whitehall Ter
Queens Village, NY 11427-1720
Phone (646) 734-1572
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007236 | NY | MD | Mental Health Counselor |
| 4884 TP | MA | MD | Optometrist |
| 3246 AT | OR | MD | Optometrist |
| 4884 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386288000000",
"number": "1447430921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20615 WHITEHALL TER",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114271720",
"telephone_number": "646-734-1572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 WORCESTER ST",
"address_2": "C/O HEALTHDRIVE",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024823717",
"telephone_number": "617-964-6681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "CHRYSTIE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-13",
"last_updated": "2013-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3246 AT",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4884 TP",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "007236",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wellesley, MA
- Harvard Vanguard Medical Assoc.
- Harvard Vanguard Medical Associates
- Harvard Vanguard Medical Associates
- Caileen Harvey, M.A. CCC-SLP
- Brenda E Haynes, MD
- Health Programs International, Inc.
- Healthcare Without Walls
- Healthdrive Podiatry Group, PC (HealthDrive Podiatry Group)
- Heather F. Adams, PH.D., LLC
- Heather O. Davidson, MD, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.