Individual provider Active NPI

Savannah Nykol Haney

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1528774635
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9116972 Issued in FL
Practice address
3700 NW 83Rd St
Gainesville, FL 32606-5603
Phone
(352) 371-7546
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9116972 FL Primary

Addresses

Primary practice location

3700 NW 83Rd St
Gainesville, FL 32606-5603

Mailing address

860 Turkey CRK
Alachua, FL 32615-9313
Phone (352) 246-2384

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230517000346 FL Practitioner - Physician Assistant 6507222569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Skin Cancer and Dermatology Specialists, PAGroup PAC ID 4082518881, 9 clinicians

Practice addresses (Care Compare)

3140 NW Medical Ctr LN
Suite 180
Lake City, FL 32055-4762
Phone (352) 371-7546

3700 NW 83Rd St
Gainesville, FL 32606-5603
Phone (352) 371-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9116972FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Gainesville, LLC CurrentSince Jan 29, 2023 Accepting new patients

Locations

3700 NW 83rd St
Gainesville, FL 32606
Phone (352) 371-7546

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1528774635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 TURKEY CRK",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159313",
            "telephone_number": "352-246-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 NW 83RD ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065603",
            "telephone_number": "352-371-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "SAVANNAH",
        "middle_name": "NYKOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.