Individual provider Active NPI

Reanna Pickerign, NP

  • Family Nurse Practitioner
  • Hillsdale, MI
National Provider Identifier
1104284827
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704619371 Issued in MI
Practice address
12 E Bacon St
Hillsdale, MI 49242-1616
Phone
(517) 437-7040
NPI assigned
Feb 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704619371 MI Primary
Nurse Practitioner 363L00000X 4704619371 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704319371 MI

Addresses

Primary practice location

12 E Bacon St
Hillsdale, MI 49242-1616

Mailing address

12 E Bacon St
Hillsdale, MI 49242-1616
Phone (517) 437-7040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160329001318 MI Practitioner - Nurse Practitioner 8729383989 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

168 S Howell St
Hillsdale, MI 49242-2040
Phone (517) 437-4451

240 W Carleton Rd
Hillsdale Health and Wellness
Hillsdale, MI 49242-5034
Phone (517) 437-7040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704619371MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsdale Community Health Center CurrentSince Sep 1, 2018 Accepting new patients

Locations

1456 Hudson Rd
Hillsdale, MI 49242
Phone (517) 439-0200

183 Hillsdale St
Hillsdale, MI 49242

240 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-7040

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242
Phone (269) 969-6196

12 E Bacon St
Hillsdale, MI 49242
Phone (517) 437-7040

Interoperability endpoints

  • Direct secure messaging: apickerign189881@direct.parkviewexchange.com

Organizations & group practices 1

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

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": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1104284827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 E BACON ST",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421616",
            "telephone_number": "517-437-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E BACON ST",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421616",
            "telephone_number": "517-437-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERIGN",
        "first_name": "REANNA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704619371",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704619371",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704319371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.