Individual provider Active NPI

Michael Pickett, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1235696147
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26130 Issued in TN
Practice address
1265 Union Ave
Memphis, TN 38104-3415
Phone
(901) 685-2696
NPI assigned
Feb 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 188988 TN
Certified Registered Nurse Anesthetist 367500000X 26130 TN Primary

Addresses

Primary practice location

1265 Union Ave
Memphis, TN 38104-3415

Mailing address

6060 Primacy Pkwy Ste 241
Memphis, TN 38119-5743
Phone (901) 725-5846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191002000709 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052641255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Tennessee, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Memphis Anesthesia Services PLCGroup PAC ID 1850386038, 26 clinicians

Practice addresses (Care Compare)

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

255 S Pauline St
Memphis, TN 38104-3221
Phone (901) 759-3100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188988TNMDRegistered Nurse
26130TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Anesthesia Group, PA CurrentSince Jul 15, 2019 Accepting new patients
East Memphis Anesthesia Services PLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1235696147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 PRIMACY PKWY STE 241",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195743",
            "telephone_number": "901-725-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-685-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "188988",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "26130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.