Individual provider Active NPI

Catherine Haynes, CFNP

  • Nurse Practitioner
  • Saucier, MS
National Provider Identifier
1568439602
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R789598 Issued in MS
Practice address
23453 Central Drive
Saucier, MS 39574-7521
Phone
(228) 832-7223
Fax
(228) 374-0856
NPI assigned
Mar 8, 2006
Last updated
Oct 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R789598 MS Primary
Family Nurse Practitioner 363LF0000X R789598 MA

Addresses

Primary practice location

23453 Central Drive
Saucier, MS 39574-7521

Mailing address

12261 Highway 49
Ste 11
Gulfport, MS 39503-2976
Phone (228) 374-2494

Other identifiers 1

IdentifierTypeStateIssuer
00125384MedicaidMS

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R789598MSMDNurse Practitioner
R789598MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Health Center, Inc Past Accepting new patients
Coastal Family Health Center Past Accepting new patients
Coastal Family Health Center Inc Past Accepting new patients

Organizations & group practices 3

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1568439602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12261 HIGHWAY 49",
            "address_2": "STE 11",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032976",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23453 CENTRAL DRIVE",
            "city": "SAUCIER",
            "state": "MS",
            "postal_code": "395747521",
            "telephone_number": "228-832-7223",
            "fax_number": "228-374-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R789598",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "R789598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125384",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saucier, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.