Active NPI
Ann Marie Haines, COTA
- Contractor
- Georgetown, KY
National Provider Identifier
1881975100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- KYA2951
- Practice address
- 100 Saint Luke Dr
Georgetown, KY 40324-1364 - Phone
- (502) 863-7900
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | KYA2951 | KY | Primary |
Addresses
Primary practice location
100 Saint Luke Dr
Georgetown, KY 40324-1364
Mailing address
3352 Squire Creek Way
Lexington, KY 40515-5392
Phone (859) 699-1687
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 |
|---|---|---|---|
| KYA2951 | KY | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1881975100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3352 SQUIRE CREEK WAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405155392",
"telephone_number": "859-699-1687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SAINT LUKE DR",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403241364",
"telephone_number": "502-863-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "ANN",
"middle_name": "MARIE",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "KY",
"license": "KYA2951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.