Individual provider Active NPI

Samantha Elizabeth Pickett, CRNP

  • Family Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1063950319
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-087692 Issued in AL
Practice address
635 N Main St Ste 3
Enterprise, AL 36330-1748
Phone
(334) 475-2680
Fax
(855) 583-3701
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-087692 AL Primary

Addresses

Primary practice location

635 N Main St Ste 3
Enterprise, AL 36330-1748

Mailing address

635 N Main St Ste 3
Enterprise, AL 36330-1748
Phone (334) 475-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170509000132 AL Practitioner - Nurse Practitioner 7214214873 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

806 Glover Ave
Suite a
Enterprise, AL 36330-2018
Phone (334) 475-2680

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority CurrentSince May 21, 2017 Accepting new patients
By His Grace Primary Care, LLC CurrentSince Jun 6, 2023 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Enterprise Urgent Care CurrentSince Mar 21, 2017 Accepting new patients
Ivycreek of Elmore LLC PastSince Mar 1, 2022 Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

635 N Main St
Ste 3
Enterprise, AL 36330

6582 Boll Weevil Cir
Enterprise, AL 36330
Phone (334) 347-2027

806 Glover Ave
Enterprise, AL 36330
Phone (334) 489-4649

806 Glover Ave
#A
Enterprise, AL 36330
Phone (334) 347-4800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DECBDD/Endpoint/DECBDD

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1063950319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N MAIN ST STE 3",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301748",
            "telephone_number": "334-475-2680",
            "fax_number": "855-583-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N MAIN ST STE 3",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301748",
            "telephone_number": "334-475-2680",
            "fax_number": "855-583-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-087692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.