GARY MICHAEL HAYNIE (NPI# 1912999475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912999475 |
| Entity Type | Individual |
| Full Name | GARY MICHAEL HAYNIE |
| Credential | MD |
| Practice Address |
1500 Line Avenue Suite 100 Shreveport LA 71101 |
| Mailing Address |
1534 Elizabeth Ave Ste 301 Shreveport LA 71101-4531 |
| Practice Telephone | 3186353052 |
| Practice Fax Number | 3186326087 |
| Mailing Telephone | 3186295001 |
| Mailing Fax Number | 3186295020 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2020-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 16336 | LA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 016336 | LA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2005 Landry Dr, Bossier City, LA 711113169 | 3187527850 | 3187527855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487641817 | Gary Donald Haynie | Ophthalmology | 4642 Amber Valley Pkwy S, Fargo, ND 58104-8612 | 2005-09-30 |
| Street Address |
1500 LINE AVENUE SUITE 100 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
| 1790196657 | Specialists Hospital Shreveport | Pharmacy | 1500 Line Avenue, Suite 206, Shreveport, LA 71101 | 2014-05-14 |
| 1417189465 | Clay Eric Morgan | Physician Assistant | 1500 Line Avenue, Ste 100, Shreveport, LA 71101-4639 | 2009-08-10 |
| 1659503613 | Trey M Harold | Physician Assistant | 1500 Line Avenue, Suite 100, Shreveport, LA 71101-4639 | 2009-08-10 |
| 1104057694 | Specialists Hospital Shreveport, LLC | Prosthetic/Orthotic Supplier | 1500 Line Avenue, Suite 206, Shreveport, LA 71101-4639 | 2009-07-31 |
| 1598891491 | Stephen Michael Brandao Jr. | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
| 1992831895 | Joseph Michael Angelo | Physician Assistant | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-02-26 |
| 1891821583 | Chris D Howard | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
| 1255470118 | John David Googe | Orthopaedic Surgery | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-02-06 |
| 1346393816 | Michele Allison | Occupational Therapist | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255624169 | Wk Orthopedic Specialty Center | Orthopaedic Surgery | 2551 Greenwood Rd Ste 130, Shreveport, LA 71103-3984 | 2011-05-25 |
| 1891013637 | Charles Marion Lobrano IIi | Orthopaedic Surgery | 1500 Line Ave Ste 100, Shreveport, LA 71101-4644 | 2010-05-04 |
| 1346451648 | Oner Ali Khera | Orthopaedic Surgery | 8001 Youree Dr Ste 450, Shreveport, LA 71115-2333 | 2007-05-25 |
| 1225149289 | James Aaron Albright | Orthopaedic Surgery | 3932 Fairfield Ave, Shreveport, LA 71106-1014 | 2006-08-31 |
| 1740209519 | John Joseph Ward | Orthopaedic Surgery | 1512 W Kirby Pl, Department of Orthopaedics, Shreveport, LA 71103-3822 | 2006-07-19 |
| 1841229978 | Cambize Shahrdar, Jr Jr. | Orthopaedic Surgery | 7925 Youree Drive, Suite 200, Shreveport, LA 71105-5127 | 2006-07-01 |
| 1184610271 | James L Zumbrunnen | Orthopaedic Surgery | 7925 Youree Dr, Suite 200, Shreveport, LA 71105-5127 | 2005-09-23 |
| 1598758849 | David D Waddell | Orthopaedic Surgery | 6999 Bickham Rd, Shreveport, LA 71107-8398 | 2005-08-23 |
| 1164427829 | Stephen L. Cox | Orthopaedic Surgery | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4644 | 2005-06-17 |
| 1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.