LJ Haynes Company

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LJ HAYNES COMPANY

Practice address

1115 Fort Worth Hwy Ste 1200
Weatherford, TX 76086-4570

Phone

(817) 594-9200

Fax

(817) 594-9202

NPI assigned

Jun 7, 2017

Organization subpart

No

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

Authorized official

Name

Ashtyn Samantha Haynes, MSCPM

Title

Secretary

Phone

(817) 594-9200

Specialties & licenses 1

Addresses

Other names 1

• Haynes Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Poonam Vasant Mankar, PT

  • Physical Therapist
  • Arlington, TX
  • NPI 1487268249
  Medicare reassignment NPD
• Luke Jason Haynes, PT, DPT

  • Physical Therapist
  • Weatherford, TX
  • NPI 1689671612
  Medicare reassignment
• Megan Reid, DPT

  • Physical Therapist
  • Weatherford, TX
  • NPI 1386559425
  NPD (past)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1922537570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760860237",
            "telephone_number": "817-594-9200",
            "fax_number": "817-594-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 FORT WORTH HWY STE 1200",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864570",
            "telephone_number": "817-594-9200",
            "fax_number": "817-594-9202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Hubbard St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mineral Wells",
            "state": "TX",
            "postal_code": "760675320",
            "country_code": "US",
            "telephone_number": "940-412-9200",
            "fax_number": "817-594-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LJ HAYNES COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "ASHTYN",
        "authorized_official_middle_name": "SAMANTHA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "817-594-9200",
        "authorized_official_credential": "MSCPM"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haynes Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haynes Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cheyenne Lopez, RBT
• Skyler Saige Lott

• Physical Therapist in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.