Individual provider Active NPI

Mitchell Dalton Haynes, OD

  • Optometrist
  • Pikeville, KY
National Provider Identifier
1629966023
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2434DT Issued in KY
Practice address
147 Sycamore St
Pikeville, KY 41501-9118
Phone
(606) 262-3055
NPI assigned
Jun 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2434DT KY Primary

Addresses

Primary practice location

147 Sycamore St
Pikeville, KY 41501-9118

Mailing address

147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 262-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825000270 KY Practitioner - Optometry 2567962525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of PikevilleGroup PAC ID 6709120942, 18 clinicians
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 218-5528

911 Bypass Rd
BLDG a
Pikeville, KY 41501-1689
Phone (606) 430-3500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pikeville Medical Center Inc CurrentSince Feb 2, 2026 Accepting new patients
University of Pikeville Optometrist CurrentSince Jul 25, 2025 Accepting new patients
Pikeville Medical Center Inc. Optometrist CurrentSince Feb 2, 2026 Accepting new patients

Locations

41 Triangle St
Martin, KY 41649
Phone (606) 218-5540

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

387 Town Mountain Rd
Ste 107
Pikeville, KY 41501
Phone (606) 218-5540

147 Sycamore St
#858
Pikeville, KY 41501

147 Sycamore St
Pikeville, KY 41501
Phone (606) 218-5250

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1629966023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019118",
            "telephone_number": "606-262-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019118",
            "telephone_number": "606-262-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "MITCHELL",
        "middle_name": "DALTON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2434DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.