Individual provider Active NPI

David Eakin II, M.D.

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1598726143
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21962 Issued in OK
Practice address
1408 S Denver Ave
Tulsa, OK 74119-3423
Phone
(918) 808-2473
Fax
(918) 608-1047
NPI assigned
Mar 31, 2006
Last updated
Jul 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 21962 OK Primary

Addresses

Primary practice location

1408 S Denver Ave
Tulsa, OK 74119-3423

Mailing address

1408 S Denver Ave
Tulsa, OK 74119-3423
Phone (918) 808-2473

Other identifiers 1

IdentifierTypeStateIssuer
200023860AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040621001113 OK Practitioner - Psychiatry 9234114653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creoks Mental Health ServicesGroup PAC ID 0749591469, 39 clinicians

Practice addresses (Care Compare)

4103 S Yale Ave
Tulsa, OK 74135-6002
Phone (918) 495-4110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21962OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Dec 24, 2019 Accepting new patients
St. John Physicians, Inc. Psychiatry Current Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1598726143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 S DENVER AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741193423",
            "telephone_number": "918-808-2473",
            "fax_number": "918-608-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 S DENVER AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741193423",
            "telephone_number": "918-808-2473",
            "fax_number": "918-608-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKIN",
        "first_name": "DAVID",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "21962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200023860A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.