Individual provider Active NPI

Jennifer Lee Hailey, D.O.

  • Psychiatry Physician
  • Lubbock, TX
National Provider Identifier
1205046133
Registry record updated Apr 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
54677-21 Issued in WI
Practice address
3223 S Loop 289 Ste 600
Lubbock, TX 79423-1372
Phone
(833) 351-8255
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2025

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101016903 MI
Psychiatry Physician 2084P0800X 20A12663 CA
Psychiatry Physician 2084P0800X 007036 AZ
Psychiatry Physician 2084P0800X DR.0059255 CO
Psychiatry Physician 2084P0800X DO04949 IA
Psychiatry Physician 2084P0800X 036142932 IL
Psychiatry Physician 2084P0800X 02004896A IN
Psychiatry Physician 2084P0800X DO2643 ME
Psychiatry Physician 2084P0800X DO2169 NV
Psychiatry Physician 2084P0800X 34.012489 OH
Psychiatry Physician 2084P0800X 5983 OK
Psychiatry Physician 2084P0800X 40620 SC
Psychiatry Physician 2084P0800X 0102204680 VA
Psychiatry Physician 2084P0800X 077581 GA
Psychiatry Physician 2084P0800X 54677-21 WI Primary

Addresses

Primary practice location

3223 S Loop 289 Ste 600
Lubbock, TX 79423-1372

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208

Other practice location 1

9805 Double R Blvd Ste 300
Reno, NV 89521-4827
Phone (833) 351-8255

Other practice location 2

550 Congressional Blvd Ste 115
Carmel, IN 46032-5644
Phone (833) 351-8255

Other practice location 3

201 Robert S Kerr Ave Ste 700
Oklahoma City, OK 73102-4203
Phone (833) 351-8255

Other practice location 4

2921 Landmark Pl Ste 215
Madison, WI 53713-4248
Phone (833) 351-8255

Other practice location 5

100 Pine St Ste 1250
San Francisco, CA 94111-5235
Phone (833) 351-8255

Other practice location 6

53 Frontage Rd Fl 1
Hampton, NJ 08827-4031
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250107001382 NV Practitioner - Psychiatry 6800977596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

9550 S Eastern Ave
Suite 253
Las Vegas, NV 89123-8042
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
12663CAMDChiropractor
007036AZMDPsychiatry Physician
20A12663CAMDPsychiatry Physician
DR.0059255COMDPsychiatry Physician
077581GAMDPsychiatry Physician
DO04949IAMDPsychiatry Physician
036142932ILMDPsychiatry Physician
02004896AINMDPsychiatry Physician
DO2643MEMDPsychiatry Physician
5101016903MIMDPsychiatry Physician
DO2169NVMDPsychiatry Physician
34.012489OHMDPsychiatry Physician
5983OKMDPsychiatry Physician
0102204680VAMDPsychiatry Physician
54677-21WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Feb 24, 2025 Accepting new patients
The Redi Clinic of Wauwatosa, SC PastSince Jan 1, 2001 Accepting new patients
Community Mental Health for Central Michigan Psychiatry PastSince Feb 13, 2003 Accepting new patients
Community Mental Health for Central Michigan Psychiatry PastSince Nov 24, 2019 Accepting new patients
Erc Wisconsin, LLC PastSince Aug 8, 2021 Accepting new patients

Locations

550 Congressional Blvd
Ste 115
Carmel, IN 46032

9550 S Eastern Ave
Ste 253
Las Vegas, NV 89123
Phone (702) 381-0980

9805 Double R Blvd
Ste 300
Reno, NV 89521
Phone (775) 412-7385

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

201 Robert S Kerr Ave
Ste 700
Oklahoma City, OK 73102
Phone (201) 687-9627

3223 S Loop 289
Ste 600
Lubbock, TX 79423
Phone (405) 314-0960

2921 Landmark Pl
Ste 215
Madison, WI 53713
Phone (608) 301-5212

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745107200000",
    "number": "1205046133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 S LOOP 289 STE 600",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231372",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9805 Double R Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895214827",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Congressional Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325644",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Robert S Kerr Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731024203",
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            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2921 Landmark Pl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Madison",
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            "postal_code": "537134248",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Pine St Ste 1250",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941115235",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 Frontage Rd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "NJ",
            "postal_code": "088274031",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAILEY",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-04-20",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101016903",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A12663",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "007036",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0059255",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "DO04949",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036142932",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "02004896A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "DO2643",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "DO2169",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.012489",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "5983",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "40620",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102204680",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "077581",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "54677-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.