Rebecca Haynes, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Monroe, GA
NPI 1629508783 · NPPES record last updated Oct 14, 2025
Key facts
- NPI
- 1629508783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- APRN-NP209240 (GA)
- Practice address
- 80 Parker Dr
Monroe, GA 30656-4747 - Phone
- (678) 381-2630
- Fax
- (678) 381-2627
- NPI assigned
- Jun 12, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209240 | GA | MD | Registered Nurse |
| APRN-NP209240 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grayson Pediatrics, LLC | Current | Accepting new patients | |
| Grayson Pediatrics, LLC | Pediatrics | Current |
Accepting new patients |
Locations
297 Cooper Rd
Loganville, GA 30052
Phone (678) 381-2627
80 Parker Dr
Monroe, GA 30656
Phone (678) 381-2630
Interoperability endpoints
- rebecca.haynes.1@28046.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 209240 | GA | |
| Pediatric Nurse Practitioner | 363LP0200X | APRN-NP209240 | GA | Yes |
Addresses
Primary practice location
80 Parker Dr
Monroe, GA 30656-4747
Mailing address
297 Cooper Rd
Loganville, GA 30052-2518
Phone (783) 812-6306
Other practice location 1
297 Cooper Rd
Loganville, GA 30052-2518
Phone (678) 381-2627
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003191294B | Medicaid | GA |
Other names
- Rebecca Ellenberger
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rebecca.haynes.1@28046.direct.athenahealth.com | Direct | Grayson Pediatrics, LLC |
Other providers in Monroe, GA
- Lisa Tolmich Haughey
- Sandra Harrison Haupt
- Sherie Teresa Hawkins
- Joseph Michael Hayek
- George David Hayes
- Head to Toe Research & Wellness, LLC
- Ashley Ruth Head
- Healthy Home Transitions
- Hearing Improvement Center of Monroe, LLC
- Holly Angelica Star Henderson
All providers in Monroe, GA · Pediatric Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.