Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacy D Donnelly, DO

Individual provider Psychiatry Physician · NPI 1457937138

Jacy D Donnelly, DO is a Psychiatry in Broken Arrow, Oklahoma. Qualified in 2021, 5 years ago. Practices with Parkside, Inc, a 15-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

512 W Atlanta St
Broken Arrow, OK 74012-7004
Phone: (918) 370-4461
Fax: (918) 512-4723
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 7721 (OK)

Record details

NPI number1457937138
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 22, 2021
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing address5310 E 31st St Ste Ll, Tulsa, OK 74135-5018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Parkside, Inc. — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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