Active NPI
Lettie Jane Haynes, FNP
- Family Nurse Practitioner
- Spartanburg, SC
National Provider Identifier
1861817819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 18714
- Practice address
- 2995 Reidville Rd
Spartanburg, SC 29301-5628 - Phone
- (864) 587-3000
- NPI assigned
- Feb 27, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 18714 | SC | Primary |
| Family Nurse Practitioner | 363LF0000X | RN187039 | GA |
Addresses
Primary practice location
2995 Reidville Rd
Spartanburg, SC 29301-5628
Mailing address
PO Box 689022
Franklin, TN 37068-9022
Phone (615) 778-8540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003157892A | Medicaid | GA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18714 | SC | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464307200000",
"number": "1861817819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 689022",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370689022",
"telephone_number": "615-778-8540",
"fax_number": "615-628-6877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2995 REIDVILLE RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293015628",
"telephone_number": "864-587-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "LETTIE",
"middle_name": "JANE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-27",
"last_updated": "2016-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "18714",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN187039",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003157892A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.