Individual provider Active NPI

Maricruz Haines, APRN

  • Nurse Practitioner
  • Guymon, OK
National Provider Identifier
1457066458
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
221870 Issued in OK
Practice address
123 Medical Dr
Guymon, OK 73942-3606
Phone
(580) 338-3361
Fax
(580) 338-1021
NPI assigned
Jan 16, 2023
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 221870 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

123 Medical Dr
Guymon, OK 73942-3606

Mailing address

1700 SW College Ave
Topeka, KS 66621-0001

Other names 1

  • Maricruz Headrick Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250704000364 OK Practitioner - Nurse Practitioner 0446764203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical CenterGroup PAC ID 7517941651, 62 clinicians

Practice addresses (Care Compare)

123 Medical Dr
Guymon, OK 73942-3606
Phone (580) 338-3361

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Center CurrentSince Apr 11, 2025 Accepting new patients
Southwest Medical Center CurrentSince Apr 11, 2025 Accepting new patients
Southwest Medical Center Past Accepting new patients

Locations

123 Medical Dr
Guymon, OK 73942
Phone (580) 338-3361

421 Medical Dr
Guymon, OK 73942
Phone (580) 338-3135

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1457066458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SW COLLEGE AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666210001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MEDICAL DR",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739423606",
            "telephone_number": "580-338-3361",
            "fax_number": "580-338-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "MARICRUZ",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "221870",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARICRUZ",
            "last_name": "HEADRICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Guymon, OK

Sources for this page

Verify at the official NPI Registry.