Individual provider Active NPI

Jessica Pickard, DDS

  • Dentist
  • Auburn, IN
National Provider Identifier
1164650933
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011304A Issued in IN
Practice address
1202 N Main St
Auburn, IN 46706-1232
Phone
(260) 925-2812
Fax
(260) 925-2864
NPI assigned
Jun 30, 2009
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN4108 ME
Dentist 122300000X 12011304A IN Primary

Addresses

Primary practice location

1202 N Main St
Auburn, IN 46706-1232

Mailing address

1202 N Main St
Auburn, IN 46706-1232
Phone (260) 925-2812

Other identifiers 1

IdentifierTypeStateIssuer
1164650933OtherINNPI

Other names 1

  • Jessica Pickard Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150618000882 IN Order and Referring Only - DentistPractitioner - Dentist 1153632013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN4108MEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary a. Scheumann, D.D.S., P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1164650933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 N MAIN ST",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467061232",
            "telephone_number": "260-925-2812",
            "fax_number": "260-925-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 N MAIN ST",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467061232",
            "telephone_number": "260-925-2812",
            "fax_number": "260-925-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD",
        "first_name": "JESSICA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4108",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011304A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164650933",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PICKARD",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

Verify at the official NPI Registry.