Individual provider Active NPI

Derek Hunter Hayes, D.M.D.

  • Dentist
  • Bowling Green, KY
National Provider Identifier
1679947246
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9695 Issued in KY
Practice address
1430 Jenny CT
Bowling Green, KY 42103-4764
Phone
(270) 791-5589
NPI assigned
Nov 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9695 KY Primary

Addresses

Primary practice location

1430 Jenny CT
Bowling Green, KY 42103-4764

Mailing address

1430 Jenny CT
Bowling Green, KY 42103-4764
Phone (270) 791-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20161014001456 SC Order and Referring Only - DentistPractitioner - Dentist 4284922808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9695KYMDDentist
8682SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1679947246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JENNY CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421034764",
            "telephone_number": "270-791-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JENNY CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421034764",
            "telephone_number": "270-791-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "DEREK",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.