Individual provider Active NPI

Carole Anne Dye Haire, D.O.

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1922074228
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16935 Issued in MS
Practice address
2633 Traceland Drive
Tupelo, MS 38801
Phone
(662) 205-4652
Fax
(662) 205-4651
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16935 MS Primary

Addresses

Primary practice location

2633 Traceland Drive
Tupelo, MS 38801

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Phone (877) 348-1281

Other identifiers 1

IdentifierTypeStateIssuer
00126275MedicaidMS

Other names 1

  • Anne Haire Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100527000790 MS Practitioner - Family Practice 3375672454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

2633 Traceland Dr
Tupelo, MS 38801-4238
Phone (662) 205-4652

Hospital & facility affiliations

  • North Mississippi Medical Ctr HHA Home health agency, Tupelo, MS, CCN 257002
  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
16935MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
BMC - Attala, LLC Family Medicine PastSince Jun 30, 2024 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Family Medicine PastSince Jun 30, 2024 Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

2633 Traceland Dr
Tupelo, MS 38801
Phone (662) 205-4652

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1922074228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281",
            "fax_number": "901-227-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 TRACELAND DRIVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-205-4652",
            "fax_number": "662-205-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRE",
        "first_name": "CAROLE ANNE",
        "middle_name": "DYE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126275",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "HAIRE",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.