Individual provider Active NPI

Michael Lynn Hayes, OD

  • Optometrist
  • Benton, KY
National Provider Identifier
1801839477
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1318DT Issued in KY
Practice address
310 W 5TH St
Benton, KY 42025-1102
Phone
(270) 527-9983
Fax
(270) 527-9593
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1318DT KY Primary

Addresses

Primary practice location

310 W 5TH St
Benton, KY 42025-1102

Mailing address

310 W 5TH St
Benton, KY 42025-1102
Phone (270) 527-9983

Other identifiers 1

IdentifierTypeStateIssuer
77013183MedicaidKY

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
I20120131000821 KY Practitioner - Optometry 2860659034 Practice locations: Benton, KY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1318DTKYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1801839477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251102",
            "telephone_number": "270-527-9983",
            "fax_number": "270-527-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W 5TH ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251102",
            "telephone_number": "270-527-9983",
            "fax_number": "270-527-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "MICHAEL",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1318DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013183",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

Verify at the official NPI Registry.