Henryetta Eye Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

HENRYETTA EYE CENTER

Practice address

900 W Main St
Henryetta, OK 74437-4252

Phone

(918) 652-2345

Fax

(918) 652-2537

NPI assigned

Jun 11, 2007

Last updated

Sep 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hayden Black, ODNPI 1184294464

Title

Owner

Phone

(918) 652-2345

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hayden Dean Black, OD

  • Optometrist
  • Henryetta, OK
  • NPI 1184294464
  Medicare reassignment Care Compare group NPD Authorized official
• Sarah Elizabeth Mulliniks, OD

  • Optometrist
  • Henryetta, OK
  • NPI 1235566639
  Medicare reassignment Care Compare group NPD
• Michael L Brian, OD

  • Optometrist
  • Henryetta, OK
  • NPI 1790726842
  Medicare reassignment NPD
• Gary Jay Lavalley, O.D.

  • Optometrist
  • Henryetta, OK
  • NPI 1285676205
  Medicare reassignment NPD
• Nicholas Jon Hardgrave, O.D.

  • Optometrist
  • NPI 1285907139

  OK

  Medicare reassignment NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1174727622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744374252",
            "telephone_number": "918-652-2345",
            "fax_number": "918-652-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744374252",
            "telephone_number": "918-652-2345",
            "fax_number": "918-652-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRYETTA EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-652-2345",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200132620A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DN5710",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Kaye Haynes, FNP-C
• HC SNF Ops LLC (Heartway at Henryetta Health and Rehab)
• Henryetta Community Skilled Healthcare and Rehab LLC (Henryetta Community Skilled Healthcare and Rehab)
• Henryetta Dental Center
• Henryetta Drug LLC (Henryetta Drug)
• Henryetta Public Schools
• Henyretta Dental Center 2, PLLC
• Heritage Acquisition, LLC (Choice Health at Home - Henryetta Hospice)
• Heritage Acquisition, LLC. (Choice Health at Home - Henryetta Hospice)
• Brandon S Herrscher, DMD

• Optometrist in Henryetta, OK
• Providers in Henryetta, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.