Active NPI
William Earl Haynes, CERTIFIED OPTICIAN
- Optician
- Omaha, NE
National Provider Identifier
1861708034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 033114
- Practice address
- 3008 N 24TH St
3008 N 24TH St
Omaha, NE 68110-2026 - Phone
- (402) 451-0539
- NPI assigned
- Aug 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometric Technician | 156FX1202X | 033114 | NE | |
| Optician | 156FX1800X | 033114 | NE | Primary |
Addresses
Primary practice location
3008 N 24TH St
3008 N 24TH St
Omaha, NE 68110-2026
Mailing address
3008 N 24TH St
3008 N 24TH St
Omaha, NE 68110
Phone (402) 451-0539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4478 | Medicaid | NE |
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 |
|---|---|---|---|
| 033114 | NE | MD | Optometric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1861708034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 N 24TH ST",
"address_2": "3008 N 24TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "68110",
"telephone_number": "402-451-0539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3008 N 24TH ST",
"address_2": "3008 N 24TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681102026",
"telephone_number": "402-451-0539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "WILLIAM",
"middle_name": "EARL",
"name_prefix": "Mr.",
"credential": "CERTIFIED OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-26",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1202X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optometric Technician",
"state": "NE",
"license": "033114",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NE",
"license": "033114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4478",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.