Active NPI
David Wayne Haines, MD
- Family Medicine Physician
- Warsaw, IN
National Provider Identifier
1821054628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01022182A
- Practice address
- 2101 Dubois Dr
Warsaw, IN 46580-3210 - Phone
- (547) 267-3200
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01022182A | IN | Primary |
Addresses
Primary practice location
2101 Dubois Dr
Warsaw, IN 46580-3210
Mailing address
P.O. Box 110
Warsaw, IN 46580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100157340 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1821054628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 110",
"city": "WARSAW",
"state": "IN",
"postal_code": "46580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 DUBOIS DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803210",
"telephone_number": "547-267-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "DAVID",
"middle_name": "WAYNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01022182A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100157340",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.