NPIMap

Individual provider Active NPI

Kim Anne Pickett, PHD, APRN

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1437224615
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17491 Issued in SC
Practice address
877 W Faris Rd Ste D
Greenville, SC 29605-4296
Phone
(864) 455-9031
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 17491 SC Primary
Nurse Practitioner 363L00000X 17491 SC
Family Nurse Practitioner 363LF0000X NP07598 OH

Addresses

Primary practice location

877 W Faris Rd Ste D
Greenville, SC 29605-4296

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other practice location 1

853 N Church St
Suite 720C
Spartanburg, SC 29303-3098
Phone (864) 560-6419

Other practice location 2

1888 Boiling Springs Rd
Boiling Springs, SC 29316-5124
Phone (864) 599-0920

Other identifiers 4

IdentifierTypeStateIssuer
NP1908MedicaidSC
7006002MedicaidNC
P01001850OtherSCRAILROAD MEDICARE
SC72645019OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpickett40518@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20111020000014 SC Practitioner - Nurse Practitioner 8921901380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

1530 Drayton Rd
Spartanburg, SC 29307
Phone (864) 560-8777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NP07598OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Osama Al-Samkari M.D. Inc Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Mvhe Inc Past Accepting new patients
Neurosurgery Inc Past Accepting new patients
Samaritan Emergency Corp Past Accepting new patients

Locations

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: kpickett40518@direct-srhs.et0939.epichosted.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1437224615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FARIS RD STE D",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054296",
            "telephone_number": "864-455-9031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "853 N Church St",
            "address_2": "Suite 720C",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033098",
            "country_code": "US",
            "telephone_number": "864-560-6419",
            "fax_number": "864-560-7498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1888 Boiling Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "SC",
            "postal_code": "293165124",
            "country_code": "US",
            "telephone_number": "864-599-0920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "KIM",
        "middle_name": "ANNE",
        "name_prefix": "Prof.",
        "credential": "PHD, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "17491",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "17491",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP07598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1908",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006002",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01001850",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC72645019",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpickett40518@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kpickett40518@direct-srhs.et0939.epichosted.com",
            "address_1": "853 N Church St",
            "address_2": "Suite 720C",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.