Individual provider Active NPI

John Tim Haskett, G.N.P.

  • Primary Care Nurse Practitioner
  • McKinleyville, CA
National Provider Identifier
1659405728
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
6064 Issued in CA
Practice address
4410 Chaffin Rd
McKinleyville, CA 95519-8029
Phone
(707) 845-2570
Fax
(888) 960-9819
NPI assigned
Mar 14, 2007
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 6064 CA Primary

Addresses

Primary practice location

4410 Chaffin Rd
McKinleyville, CA 95519-8029

Mailing address

PO Box 6860
Eureka, CA 95502-6860
Phone (707) 443-3384

Other practice location 1

1910 California St
Eureka, CA 95501-2870
Phone (707) 443-9747

Other practice location 2

720 Wood St
Eureka, CA 95501-4413
Phone (707) 445-7710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101130000399 CA Practitioner - Nurse Practitioner 4981890555 Practice locations: McKinleyville, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Diego School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4410 Chaffin Rd
McKinleyville, CA 95519-8029
Phone (707) 845-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Hospital & facility affiliations 2

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1659405728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6860",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026860",
            "telephone_number": "707-443-3384",
            "fax_number": "707-443-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 CHAFFIN RD",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955198029",
            "telephone_number": "707-845-2570",
            "fax_number": "888-960-9819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 California St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955012870",
            "country_code": "US",
            "telephone_number": "707-443-9747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 Wood St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955014413",
            "country_code": "US",
            "telephone_number": "707-445-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASKETT",
        "first_name": "JOHN",
        "middle_name": "TIM",
        "name_prefix": "Mr.",
        "credential": "G.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "6064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinleyville, CA

Sources for this page

Verify at the official NPI Registry.