Individual provider Active NPI

Tina Gay Hayes, O.D.

  • Optometrist
  • Jackson, MI
National Provider Identifier
1669575361
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MI 4901003758 Issued in MI
Practice address
1617 N West Ave
Jackson, MI 49202-2030
Phone
(517) 780-3828
Fax
(517) 780-4959
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MI 4901003758 MI Primary

Addresses

Primary practice location

1617 N West Ave
Jackson, MI 49202-2030

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Tina Gay Sanford Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI 4901003758MIMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1669575361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022030",
            "telephone_number": "517-780-3828",
            "fax_number": "517-780-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "TINA",
        "middle_name": "GAY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "MI 4901003758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "SANFORD",
            "middle_name": "GAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.