NPIMap

Individual provider Active NPI

John R Hines, D.O.

  • Family Medicine Physician
  • Morton, WA
National Provider Identifier
1629031950
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61532255 Issued in WA
Practice address
521 Adams Ave Ste B
Morton, WA 98356-9323
Phone
(360) 496-5145
NPI assigned
Apr 8, 2006
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61532255 WA Primary
Family Medicine Physician 207Q00000X E3472 AR

Addresses

Primary practice location

521 Adams Ave Ste B
Morton, WA 98356-9323

Mailing address

PO Box 1138
Morton, WA 98356-0019
Phone (360) 496-3688

Other practice location 1

1300 W Court St
Paragould, AR 72450-4105
Phone (870) 236-4100

Other identifiers 4

IdentifierTypeStateIssuer
150835003MedicaidAR
5M478OtherARMEDICARE INDIVIDUAL
P00115537OtherARRAIL ROAD MEDICARE
5M478OtherARBLUE CROSS BLUE SHIELD INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031118000557 AR Practitioner - Family PracticePractitioner - Emergency Medicine 8729992243
I20240531003284 WA Practitioner - Family Practice 8729992243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis County Hospital District No 1Group PAC ID 6002727385, shared by 7 NPIs, 27 clinicians

Practice addresses (Care Compare)

521 Adams Ave
Morton, WA 98356-9323

531 Adams Ave
Morton, WA 98356-9323

PO Box
Suite 1138
Morton, WA 98356-0019

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E3472ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Hospital District No 1 CurrentSince Jun 1, 2024 Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Jun 1, 2024 Accepting new patients
Lewis County Hospital District No. 1 Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Northeast Arkansas Clinic, PA Past Accepting new patients
St Bernards Hospital Inc. Past Accepting new patients
Doctors Health Group, Inc Family Medicine PastSince Jul 27, 2004 Accepting new patients
Harris Family Medicine, PLLC Family Medicine Past Accepting new patients
Lewis County Hospital District No. 1 Past Accepting new patients

Locations

108 Kindle Rd
Randle, WA 98377
Phone (360) 497-3333

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1629031950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1138",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983560019",
            "telephone_number": "360-496-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ADAMS AVE STE B",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983569323",
            "telephone_number": "360-496-5145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 W Court St",
            "address_purpose": "LOCATION",
            "city": "Paragould",
            "state": "AR",
            "postal_code": "724504105",
            "country_code": "US",
            "telephone_number": "870-236-4100",
            "fax_number": "870-236-4122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61532255",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E3472",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150835003",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "5M478",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00115537",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD INDIVIDUAL",
            "identifier": "5M478",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, WA

Sources for this page

Verify at the official NPI Registry.