Individual provider Active NPI

Kedra Haynes, PA

  • Physician Assistant
  • Waynesboro, VA
National Provider Identifier
1962394668
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010979 Issued in VA
Practice address
1850 Rosser Ave
Waynesboro, VA 22980-3237
Phone
(540) 942-1200
Fax
(540) 942-0151
NPI assigned
Jul 17, 2025
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010979 VA Primary
Family Medicine Physician 207Q00000X 0110010979 VA

Addresses

Primary practice location

1850 Rosser Ave
Waynesboro, VA 22980-3237

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250814001053 VA Practitioner - Physician Assistant 4981103306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816

1850 Rosser Ave
Waynesboro, VA 22980-3237
Phone (540) 942-1200

24 Gloucester Rd
Stuarts Draft, VA 24477-3321
Phone (540) 337-3710

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110010979VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jul 28, 2024 Accepting new patients
Jha MD PC PastSince Jul 22, 2025 Accepting new patients

Locations

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1850 Rosser Ave
Waynesboro, VA 22980
Phone (540) 942-1200

Interoperability endpoints

  • Direct secure messaging: khaynes683704@direct.healthsystem.virginia.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1962394668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 ROSSER AVE",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803237",
            "telephone_number": "540-942-1200",
            "fax_number": "540-942-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KEDRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010979",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110010979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

Verify at the official NPI Registry.