NPIMap

Individual provider Active NPI

Anna Marie Pickett, P.A.-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1275878324
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003603 Issued in CO
Practice address
2627 Redwing Rd Ste 300
Fort Collins, CO 80526-6310
Phone
(970) 631-8650
Fax
(833) 909-3959
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 3603 CO
Medical Physician Assistant 363AM0700X 3603 CO
Physician Assistant 363A00000X PA.0003603 CO Primary

Addresses

Primary practice location

2627 Redwing Rd Ste 300
Fort Collins, CO 80526-6310

Mailing address

2627 Redwing Rd Ste 300
Fort Collins, CO 80526-6310
Phone (970) 631-8650

Other identifiers 1

IdentifierTypeStateIssuer
38487705MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130419000156 CO Practitioner - Physician Assistant 2668618539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Wellness Familly Medicine PLLCGroup PAC ID 7214395656, 2 clinicians

Practice addresses (Care Compare)

2627 Redwing Rd
Suite 300
Fort Collins, CO 80526-6310
Phone (970) 631-8650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 3603COMDPhysician Assistant
PA.0003603COMDPhysician Assistant
3603COMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: anna.pickett.1@27163.direct.athenahealth.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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1275878324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 REDWING RD STE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266310",
            "telephone_number": "970-631-8650",
            "fax_number": "833-909-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 REDWING RD STE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266310",
            "telephone_number": "970-631-8650",
            "fax_number": "833-909-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA 3603",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3603",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38487705",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.