Individual provider Active NPI

Paula B Haynes, APRN

  • Family Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1609017193
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3795 Issued in SC
Practice address
1228 Highway 72 W
Greenwood, SC 29649-1816
Phone
(864) 943-0549
Fax
(864) 227-2067
NPI assigned
Mar 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3795 SC Primary

Addresses

Primary practice location

1228 Highway 72 W
Greenwood, SC 29649-1816

Mailing address

1228 Highway 72 W
Greenwood, SC 29649-1816
Phone (864) 943-0549

Other identifiers 1

IdentifierTypeStateIssuer
NP2942MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110127000282 SC Practitioner - Nurse Practitioner 8325227028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NHC Healthcare-Greenwood LLC 4 clinicians

Practice addresses (Care Compare)

437 E Cambridge Ave
Greenwood, SC 29646-2244
Phone (864) 223-1950

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3795SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
NHC Healthcare-Greenwood LLC CurrentSince May 12, 2019 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

437 Cambridge Ave E
Greenwood, SC 29646
Phone (864) 223-1950

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1609017193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 HIGHWAY 72 W",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491816",
            "telephone_number": "864-943-0549",
            "fax_number": "864-227-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 HIGHWAY 72 W",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491816",
            "telephone_number": "864-943-0549",
            "fax_number": "864-227-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "PAULA",
        "middle_name": "B",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2942",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.