Active NPI
J. Glenn Haines, M.D.
- Urology Physician
- Wailuku, HI
National Provider Identifier
1508836917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 3041
- Practice address
- 1830 Wells St
Ste 101
Wailuku, HI 96793-2365 - Phone
- (808) 244-3200
- Fax
- (808) 244-9793
- NPI assigned
- Jan 26, 2006
- Last updated
- Dec 20, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 3041 | HI | Primary |
Addresses
Primary practice location
1830 Wells St
Ste 101
Wailuku, HI 96793-2365
Mailing address
1830 Wells St
Ste 101
Wailuku, HI 96793-2365
Phone (808) 244-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CS8366 | Other | HI | MEDICARE RAILROAD |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warm Springs Road CVS, L.L.C. | Past | Accepting new patients | |
| Warm Springs Road CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292803200000",
"number": "1508836917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 WELLS ST",
"address_2": "STE 101",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932365",
"telephone_number": "808-244-3200",
"fax_number": "808-244-9793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 WELLS ST",
"address_2": "STE 101",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932365",
"telephone_number": "808-244-3200",
"fax_number": "808-244-9793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "J.",
"middle_name": "GLENN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2010-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "HI",
"license": "3041",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "CS8366",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.