Jeanne Sue Haynie, ANP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5004204 Issued in NC

Practice address

10130 Perimeter Pkwy
Ste 200
Charlotte, NC 28216-2447

Phone

(888) 849-7379

Fax

(855) 857-7333

NPI assigned

Feb 5, 2009

Sex

Female

Sole proprietor

No

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

Nurse Practitioner

State licenses

Practice roles

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.

• Cardinal Health Services, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Winston Salem, NC
  • NPI 1144575929
  NPD (past)
• Oldtown Immediate Care, PA

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1194060368
  NPD (past)

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1821237348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 PERIMETER PKWY",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282162447",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 PERIMETER PKWY",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282162447",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNIE",
        "first_name": "JEANNE",
        "middle_name": "SUE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "NC",
            "license": "5004204",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "175RP",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004983",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanner Haynes
• Tommie Tomika Haynes, MSW, LCAS
• Vicki Maria Haynes, QP
• William Bryce Haynes III, MD
• Angela Wilson Haynie, NP
• Brandon Scott Hays, MD
• Heidi Lisa Hays, CRNA
• Laura Martelly Hays, MD
• Margaret Hayslip, MD
• Franchesca Hayward, LCMHCA

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.