Active NPI
Dialene R Haines, STNA
- Contractor
- Brooklyn, OH
National Provider Identifier
1730743014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 402051890318
- Practice address
- 4200 Westbrook Dr Apt 110
Brooklyn, OH 44144-1201 - Phone
- (216) 777-9316
- NPI assigned
- Apr 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 402051890318 | OH | Primary |
Addresses
Primary practice location
4200 Westbrook Dr Apt 110
Brooklyn, OH 44144-1201
Mailing address
4200 Westbrook Dr Apt 110
Brooklyn, OH 44144-1201
Phone (216) 777-9316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402051890318 | Other | OH | STNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 402051890318 | OH | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1730743014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 WESTBROOK DR APT 110",
"city": "BROOKLYN",
"state": "OH",
"postal_code": "441441201",
"telephone_number": "216-777-9316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 WESTBROOK DR APT 110",
"city": "BROOKLYN",
"state": "OH",
"postal_code": "441441201",
"telephone_number": "216-777-9316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "DIALENE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "STNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "402051890318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STNA",
"identifier": "402051890318",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.