Individual provider Active NPI

Emily Anna Haynes, PA-C

  • Medical Physician Assistant
  • North Charleston, SC
National Provider Identifier
1750769014
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2317 Issued in SC
Practice address
2233 Northwoods Blvd
North Charleston, SC 29406-4007
Phone
(843) 773-9903
NPI assigned
May 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2317 SC Primary

Addresses

Primary practice location

2233 Northwoods Blvd
North Charleston, SC 29406-4007

Mailing address

113 Breakers Dr
Apt 332
Myrtle Beach, SC 29579-4423
Phone (330) 247-8295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160621002518 SC Practitioner - Physician Assistant 0941591085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2317SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Pelham Medical Center CurrentSince Jul 20, 2022 Accepting new patients
Nasoncare, LLC CurrentSince Mar 1, 2020 Accepting new patients
Spartanburg Medical Center CurrentSince Jul 20, 2022 Accepting new patients
Spartanburg Medical Center CurrentSince Jul 20, 2022 Accepting new patients
Emergency Physician Services Past Accepting new patients
Village Hospital Past Accepting new patients

Locations

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

2233 Northwoods Blvd
North Charleston, SC 29406
Phone (843) 773-9903

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1750769014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BREAKERS DR",
            "address_2": "APT 332",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794423",
            "telephone_number": "330-247-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NORTHWOODS BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064007",
            "telephone_number": "843-773-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "EMILY",
        "middle_name": "ANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.