Kala Renee Haynes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105573 Issued in FL

Practice address

335 Clyde Morris Blvd
Suite 260
Ormond Beach, FL 32174-3181

Phone

(386) 672-4001

Fax

(386) 672-4006

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Coast Nephrology Associates LLCGroup PAC ID 1355364605, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
• Adventhealth Deland Hospital, Deland, FL, CCN 100045
• Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20431/brand/1/csg/1/fhir/r4

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.

• East Coast Nephrology Associates LLC

  • Nephrology Physician
  • Ormond Beach, FL
  • NPI 1841210432
  Medicare reassignment Care Compare group
• Daytona Beach Nephrology LLC

  • Nephrology Physician
  • Port Orange, FL
  • NPI 1376193029
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Palm Coast Parkway Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1861102345
  Care Compare affiliation
• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation
• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation
• Memorial Hospital-West Volusia Inc

  • General Acute Care Hospital
  • Deland, FL
  • NPI 1649367269
  Care Compare affiliation

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1508171315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 260",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743181",
            "telephone_number": "386-672-4001",
            "fax_number": "386-672-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 260",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743181",
            "telephone_number": "386-672-4001",
            "fax_number": "386-672-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KALA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Michael Hassmann, D.C.
• Hatch Orthopedics, P.a.
• Robert Seals Hatch, M.D.
• Kirby W Haws, DO
• Kenneth Brookfield Hawthorne Jr., MD
• Brian W. Hazen, D.M.D.
• Healthcare Solution Services LLC
• Healthsense Inc
• Healthy Connection East, LLC
• Paula Jane Hearne, PTA

• Physician Assistant in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.