NPIMap

Individual provider Active NPI

Charlton Judson Pickett, M.D.

  • Family Medicine Physician
  • Augusta, GA
National Provider Identifier
1366429854
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
030528 Issued in GA
Practice address
1417 Pendleton Road
Augusta, GA 30904-4837
Phone
(706) 738-9824
Fax
(706) 736-4111
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 030528 GA Primary

Addresses

Primary practice location

1417 Pendleton Road
Augusta, GA 30904-4837

Mailing address

1417 Pendleton Road
Augusta, GA 30904-4837
Phone (706) 738-9834

Other identifiers 2

IdentifierTypeStateIssuer
00377979BMedicaidGA
140437MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090224000144 SC Practitioner - Family Practice 1951466051 Reassigns benefits to 2 organizations
Practice locations: North Augusta, SC
I20111208000605 GA Practitioner - Family Practice 1951466051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLC 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

587 Furys Ferry Rd
Martinez, GA 30907-9059
Phone (706) 721-8623

Hospital & facility affiliations

  • Trinity Home Health Home health agency, Martinez, GA, CCN 117025
  • Enhabit Home Health Home health agency, Hartwell, GA, CCN 117069
  • Amedisys Home Health Care Home health agency, Augusta, GA, CCN 117081
  • Amedisys Home Health of Lexington Home health agency, Lexington, SC, CCN 427039
  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028
  • Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082
  • NHC HealthCare - North Augusta Nursing home, North Augusta, SC, CCN 425320

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1417 Pendleton Rd
Augusta, GA 30904
Phone (706) 738-9824

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

350 Austin Graybill Rd
North Augusta, SC 29860
Phone (706) 736-5244

Organizations & group practices 4

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 10

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1366429854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON ROAD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837",
            "telephone_number": "706-738-9834",
            "fax_number": "706-736-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON ROAD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837",
            "telephone_number": "706-738-9824",
            "fax_number": "706-736-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "CHARLTON",
        "middle_name": "JUDSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00377979B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140437",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.