Individual provider Active NPI

Haylee Haines

  • Family Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1922857424
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11032845 Issued in FL
Practice address
17929 Hunting Bow Cir
Lutz, FL 33558-5378
Phone
(813) 792-8555
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11032845 FL Primary

Addresses

Primary practice location

17929 Hunting Bow Cir
Lutz, FL 33558-5378

Mailing address

17929 Hunting Bow Cir
Lutz, FL 33558-5378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240822003342 FL Practitioner - Nurse Practitioner 2264971241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11032845FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Your Family Walk-in Clinic LLC CurrentSince Jun 6, 2024 Accepting new patients

Locations

17929 Hunting Bow Cir
Lutz, FL 33558
Phone (813) 792-8555

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1922857424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17929 HUNTING BOW CIR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17929 HUNTING BOW CIR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585378",
            "telephone_number": "813-792-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "HAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11032845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.