Philip C. Haines, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

4301033971 Issued in MI

Practice address

1011 Parchment Dr SE
Grand Rapids, MI 49546-3664

Phone

(616) 957-2200

Fax

(616) 957-4274

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1679633994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463664",
            "telephone_number": "616-957-2200",
            "fax_number": "616-957-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463664",
            "telephone_number": "616-957-2200",
            "fax_number": "616-957-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "PHILIP",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301033971",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301033971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103028918",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D. NUMBER",
            "identifier": "383145416",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wajeh Haider
• Lauren N Haight
• Terra Marie Haight, LLMSW
• Joseph Haik
• Krista Marie Haines, MD
• Sawyer Brooks Haisma
• Patricia Anne Haist, MA
• Haith Place Inc
• Samer Haj-Bakri, M.D.
• Naser Hajaissa, MBBS

• Child & Adolescent Psychiatry Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.