Nichelle Haynes, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

Q6027 Issued in TX

Practice address

1407 W Stassney LN
Austin, TX 78745

Phone

(512) 440-4800

Fax

(512) 440-4835

NPI assigned

May 12, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1629489752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "512-440-4800",
            "fax_number": "512-440-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W STASSNEY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "512-440-4800",
            "fax_number": "512-440-4835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Cross Park Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78754",
            "country_code": "US",
            "telephone_number": "512-549-8021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "NICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q6027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Bernard Haynes, MD, MPH
• Cristina M Haynes, PT
• Indigo Haynes
• Marvi Arredondo Haynes, LMFT-A
• Megan Christelle Haynes, M.S., CCC-SLP
• Pamela Haynes, LCSW
• Shaunice Haynes
• Susan Craig Haynes, A.P.N.
• Hays Medical Supply LLC Judson Sturdivant Sole MBR
• Hays Medical Supply LLC Judson Sturdivant Sole MBR

• Psychiatry Physician in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.