BROOKHAVEN HOSPITAL INC. (NPI# 1023064300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023064300 |
| Entity Type | Organization |
| Organization Name | BROOKHAVEN HOSPITAL INC. |
| Practice Address |
201 S Garnett Rd Tulsa OK 74128 |
| Mailing Address |
201 S Garnett Rd Tulsa OK 74128-1805 |
| Practice Telephone | 9184384257 |
| Practice Fax Number | 9184380083 |
| Mailing Telephone | 9184384257 |
| Mailing Fax Number | 9184380083 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-08-29 |
| Authorized Official Name | DR. ROLF B GAINER (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9184384257 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273Y00000X | Rehabilitation Unit | 2313 | OK | Hospital Units |
| Y | 283Q00000X | Psychiatric Hospital | 2313 | OK | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 160837125 | 05 | |
| TN | Q029771 | 05 | |
| IA | 0901223 | 05 | |
| KS | 100299900B | 05 | |
| SD | 0157430 | 05 | |
| NE | 10026694200 | 05 | |
| OK | 100701410B | 05 | |
| WA | 1023064300 | 05 | |
| NC | 1023064300 | 05 | |
| NM | 00401269 | 05 | |
| OK | 100701410A | 05 | |
| OK | 100701410C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174660518 | Brookhaven Hospital Inc. | Psychiatric Hospital | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2007-02-01 |
| Street Address |
201 S GARNETT RD |
| City | TULSA |
| State | OK |
| Zip Code | 74128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455282 | Jordan Hearod | Case Manager/Care Coordinator | 201 S Garnett Rd, Tulsa, OK 74128-1800 | 2018-11-02 |
| 1851868798 | Victoria Maderazo | Nurse Practitioner | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2018-10-29 |
| 1316349269 | Kami Robinson | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2014-09-23 |
| 1831533421 | Charles D. Van Tuyl, Ph.d., M.d. | Psychiatry & Neurology | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2013-04-25 |
| 1073854238 | Cyndee Suzanne Johnson | Case Manager/Care Coordinator | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2013-03-12 |
| 1982943445 | Brookhaven Hospital | Community Based Residential Treatment Facility, Mental Illness | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2013-02-04 |
| 1396080347 | Karen S Lacy | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2012-12-03 |
| 1801146428 | Erika Beth Link-siemens | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2012-09-11 |
| 1417234709 | Sarah J Williams | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2011-11-15 |
| 1427333624 | M.j. Clausen | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2011-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639720352 | Nicole Piggee | Technician | 10548 East 5th Street, Tulsa, OK 74128 | 2019-09-24 |
| 1598252884 | Beth Alison Peck | Social Worker | 10159 East 11th Street, Tulsa, OK 74128 | 2018-04-23 |
| 1821434523 | Ta'vionna Danielle Polley-davis (whayne) | Counselor | 1148 E. 20th St, Unit A, Tulsa, OK 74128 | 2013-05-21 |
| 1881753572 | Mashovin Home Health Care, Inc. | Home Health | 12131 East Skelly Drive, Tulsa, OK 74128 | 2006-12-08 |
| 1841689189 | David L Hinman | Counselor | 2001 S Garnett Rd, Suite G, Tulsa, OK 74128 | 2015-01-09 |
| 1992019582 | Ryan John Wilson | Counselor | 2725 E. Skelly Dr., Suite 202, Tulsa, OK 74128 | 2010-08-06 |
| 1376786590 | Dana Furtado | Social Worker | Department of Veterans Affairs, 10159 E. 11th Street, Suite #100, Tulsa, OK 74128 | 2009-04-17 |
| 1033391370 | Genevieve Dulan | Family Medicine | 10912 E 14th St, Tulsa, OK 74128 | 2007-11-28 |
| 1215098017 | Paul Chesley Cochran | Psychiatry & Neurology | 141 S Garnett Rd, Tulsa, OK 74128 | 2006-12-13 |
| 1548700826 | Kristina Marcotte | Case Management | 9756 E 4th Pl, Tulsa, OK 74128-1247 | 2017-03-06 |
| Find all providers in zip 74128 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104224856 | Erica Gregory | Psychiatric Hospital | 211 S Garnett Rd, Tulsa, OK 74128-1805 | 2014-12-11 |
| 1437370772 | Parkside, Inc. | Psychiatric Hospital | 1619 East 13th Street, Tulsa, OK 74120-5410 | 2007-05-02 |
| 1982005971 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-09-09 |
| 1902224801 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-03-29 |
| 1750714721 | Parkside, Inc. | Psychiatric Hospital | 1619 E 13th St, Tulsa, OK 74120-5410 | 2013-08-14 |
| 1174866875 | Parkside Psychiatric Hospital & Clinic | Psychiatric Hospital | 1619 E 13th St, 1620 E. 12th, Tulsa, OK 74120-5410 | 2013-04-01 |
| 1326396391 | Parkside, Inc. | Psychiatric Hospital | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2012-08-24 |
| 1710296272 | Shadow Mountain Behavioral Health | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2010-10-01 |
| 1891988424 | John B White, Md PC | Psychiatric Hospital | 1620 E 12th St, Tulsa, OK 74120-5407 | 2007-08-27 |
| 1083807366 | Oklahoma Medical and Psychiatric Services Inc | Psychiatric Hospital | 2913 E 88th St, Tulsa, OK 74137-2508 | 2007-08-21 |
| Find all providers in TULSA | ||||
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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.