DUSTIN O. HAYES, D.O., P.C. (NPI# 1124561113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124561113 |
| Entity Type | Organization |
| Organization Name | DUSTIN O. HAYES, D.O., P.C. |
| Other Organization Name | ECLIPSE MENTAL HEALTH SERVICES |
| Practice Address |
817 S Elm Pl Suite C Broken Arrow OK 74012-5369 |
| Practice Telephone | 9189404734 |
| Practice Fax Number | 9189404737 |
| Mailing Telephone | 9189404734 |
| Mailing Fax Number | 9189404737 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2020-04-06 |
| Authorized Official Name | DR. DUSTIN O'LEATH HAYES (PRESIDENT) |
| Authorized Official Telephone | 9189404734 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 5382 | OK | Allopathic & Osteopathic Physicians |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200678490A | 05 |
| Other Name | Type Code |
|---|---|
| Eclipse Mental Health Services | Doing Business As Name - Organization |
| Eclipse Mental Health Services | Other Name - Individual/Organization |
| Street Address |
817 S ELM PL SUITE C |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-5369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164428215 | Mark Steven Hamra | Allergy & Immunology | 817 S Elm Pl, Ste 107, Broken Arrow, OK 74012-5369 | 2005-06-23 |
| 1164082707 | Adriane Paige Brower | Technician, Other | 817 S Elm Pl, Broken Arrow, OK 74012-5369 | 2019-06-17 |
| 1992254346 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 817 S Elm Pl, Suite 105, Broken Arrow, OK 74012-5369 | 2016-09-27 |
| 1790127900 | Broken Arrow Family Practice Center Plc | Clinic/Center | 817 S Elm Pl, Suite A, Broken Arrow, OK 74012-5369 | 2013-07-29 |
| 1184981144 | Dustin O'leath Hayes | Psychiatry & Neurology | 817 S Elm Pl, Suite C, Broken Arrow, OK 74012-5369 | 2012-04-16 |
| 1093993933 | Catherine S Morgan Lcsw Inc | Community/Behavioral Health | 817 S Elm Pl, B, Broken Arrow, OK 74012-5369 | 2008-02-02 |
| 1538280920 | Elizabeth Dawn Campbell | Family Medicine | 817 S Elm Pl, Broken Arrow, OK 74012-5369 | 2007-04-03 |
| 1609933100 | Stephen Lester Greer | Psychiatry & Neurology | 817 S Elm Pl, Broken Arrow, OK 74012-5369 | 2007-01-03 |
| 1659457703 | Gaurangi Manek Anklesaria | Family Medicine | 817 S Elm Pl, #104, Broken Arrow, OK 74012-5369 | 2006-10-31 |
| 1912019654 | Catherine S. Morgan | Social Worker | 817 S Elm Pl, B, Broken Arrow, OK 74012-5369 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134300049 | Melton Health and Medical Services | Clinic/Center | 1129 S Aspen Ave, Broken Arrow, OK 74012-4859 | 2007-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801375324 | Hope Restored Counseling LLC | Clinic/Center | 1211 N Shartel Ave Ste 602, Oklahoma City, OK 73103-2445 | 2018-08-07 |
| 1063903839 | Felicia Hurst Therapy LLC | Clinic/Center | 2007 N Commerce St Ste 212, Ardmore, OK 73401-1268 | 2018-05-28 |
| 1003304254 | Serenity Counseling LLC | Clinic/Center | 5103 S Sheridan Rd # 323, Tulsa, OK 74145-7627 | 2018-04-24 |
| 1750897518 | Living Hope Eating Disorder Treatment Center, Pllc | Clinic/Center | 3900 E Robinson St, Norman, OK 73026-0725 | 2017-12-15 |
| 1912337643 | Latanya Dodd | Clinic/Center | 1540 E 68th Pl, Tulsa, OK 74136 | 2013-11-15 |
| 1356787444 | Cherokee Nation | Clinic/Center | 1277 Skill Center Cir, Tahlequah, OK 74464-6495 | 2013-05-15 |
| 1548526908 | Hope Johnson | Clinic/Center | 21182 Meadow Ln, Howe, OK 74940 | 2012-04-10 |
| 1518223502 | Rohit Gautam | Clinic/Center | 9205 S Shartel Ave Apt 201, Oklahoma City, OK 73139-5214 | 2012-04-04 |
| 1679764807 | Riverside Counseling Services | Clinic/Center | 5272 S Lewis Ave Ste 250, Tulsa, OK 74105-6564 | 2007-08-05 |
| 1629268404 | Hope Counseling Services, Inc | Clinic/Center | 4411 Highline Blvd, Suite 204, Oklahoma City, OK 73108-1865 | 2007-07-27 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.