Larry Michael Pickett, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.08426 Issued in OH

Practice address

433 W High St
Bryan, OH 43506-1690

Phone

(419) 636-1131

Fax

(419) 636-3100

NPI assigned

Aug 2, 2005

Last updated

Jul 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freeman Neosho Hospital

  dba Freeman Neosho Anesthesiology

  • Anesthesiology Physician
  • Neosho, MO
  • NPI 1164451746

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Nurse Anesthesia of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Elizabeth City, NC
  • NPI 1689628729

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Taylor County Anesthesia PSC

  • Anesthesiology Physician
  • Campbellsville, KY
  • NPI 1659342178

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Wallace Thomson Hospital

  • Medical Specialty Clinic/Center
  • Union, SC
  • NPI 1588872584
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1063413813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-636-1131",
            "fax_number": "419-636-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-636-1131",
            "fax_number": "419-636-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "LARRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.08426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2626573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Peters, PSY.D.
• Randy L Peters, O.D.
• Ryan Peters I
• Darisa Phillips, COTA/L
• Mark E Phillips, D.D.S.
• Tiffany Rae Poletta, COTA/L
• Brianna Rae Pool, A-GNP
• Nicole Marie Pothast, MSN, CNM
• Rebecca Ann Powers, COTA/L
• Premier Operating Fountain Park, LLC

• Certified Registered Nurse Anesthetist in Bryan, OH
• Providers in Bryan, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.