Active NPI
Jonathan Noah Haynes, D.C.
- Chiropractor
- Queen Creek, AZ
National Provider Identifier
1518010271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7375
- Practice address
- 19035 E San Tan Blvd Ste 110
Queen Creek, AZ 85242-7177 - Phone
- (480) 882-2400
- Fax
- (480) 882-2424
- NPI assigned
- Jan 18, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7375 | AZ | Primary |
Addresses
Primary practice location
19035 E San Tan Blvd Ste 110
Queen Creek, AZ 85242-7177
Mailing address
83 W Yellow Bee Dr
Queen Creek, AZ 85243-4828
Phone (480) 782-0573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040824000160 | AZ | Practitioner - Chiropractic | 7911971106 | Practice locations: Queen Creek, AZ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
19035 E San Tan Blvd
Queen Creek, AZ 85142-7177
Phone (480) 882-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7375 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518010271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 W YELLOW BEE DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "852434828",
"telephone_number": "480-782-0573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19035 E SAN TAN BLVD STE 110",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "852427177",
"telephone_number": "480-882-2400",
"fax_number": "480-882-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "JONATHAN",
"middle_name": "NOAH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "7375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.