Individual provider Active NPI

Nancy Jane Haynes, PTA

  • Physical Therapy Assistant
  • Greenville, TX
National Provider Identifier
1902047582
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2069680 Issued in TX
Practice address
3500 Park St
Greenville, TX 75401-5159
Phone
(903) 455-2120
NPI assigned
Mar 11, 2009
Last updated
Mar 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2069680 TX Primary

Addresses

Primary practice location

3500 Park St
Greenville, TX 75401-5159

Mailing address

3011 Eastland St
Greenville, TX 75402-8919
Phone (903) 217-7947

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

LicenseStateTypeSpecialty
2069680TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1902047582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 EASTLAND ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754028919",
            "telephone_number": "903-217-7947",
            "fax_number": "903-454-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 PARK ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015159",
            "telephone_number": "903-455-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "NANCY",
        "middle_name": "JANE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2069680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.