Individual provider Active NPI

Barry L Haines, CRNA

  • Certified Registered Nurse Anesthetist
  • Lima, OH
National Provider Identifier
1467460303
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA08569-NA Issued in OH
Practice address
2793 Shawnee Rd
Lima, OH 45806-1444
Phone
(419) 879-3636
Fax
(419) 879-4312
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COA08569-NA OH Primary

Addresses

Primary practice location

2793 Shawnee Rd
Lima, OH 45806-1444

Mailing address

200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone (419) 394-3335

Other identifiers 3

IdentifierTypeStateIssuer
P00277590OtherOHRAILROAD MEDICARE
2613032MedicaidOH
000000679179OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121001013 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466471271 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buckeye Anesthesia Services and Consultants LLCGroup PAC ID 2668367376, 18 clinicians

Practice addresses (Care Compare)

801 Medical Dr
Suite B
Lima, OH 45804-4030
Phone (419) 224-7586

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA08569-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services Network LTD CurrentSince Apr 1, 2017 Accepting new patients
Buckeye Anesthesia Services & Consultants LLC CurrentSince Apr 25, 2025 Accepting new patients
The Endoscopy Center of West Central Ohio, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 8, 2019 Accepting new patients
JTDM Family Practice LLC Past Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

33151 Collection Ctr Dr
Chicago, IL 60693

1 Wyoming St
Ste 3027A
Dayton, OH 45409

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2793 Shawnee Rd
Lima, OH 45806
Phone (419) 204-1501

801 Medical Dr
Ste B
Lima, OH 45804
Phone (419) 224-7586

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1467460303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2793 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458061444",
            "telephone_number": "419-879-3636",
            "fax_number": "419-879-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "BARRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA08569-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00277590",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2613032",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000679179",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.