Sandra Wauthena Haymon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY005273 Issued in AZ

Practice address

401 Old Albany Rd
Thomasville, GA 31792-4014

Phone

(229) 228-8100

Fax

(229) 228-8154

NPI assigned

Jul 10, 2006

Last updated

Mar 20, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1538192539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 US HIGHWAY 84 W",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317920510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLD ALBANY RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924014",
            "telephone_number": "229-228-8100",
            "fax_number": "229-228-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYMON",
        "first_name": "SANDRA",
        "middle_name": "WAUTHENA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PSY005273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00822214A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.