Individual provider Active NPI

Ann Sidwell Pike, PH.D.

  • Psychologist
  • Jasper, GA
National Provider Identifier
1477600906
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1346 Issued in GA
Practice address
201 Cove Rd
Jasper, GA 30143-1356
Phone
(706) 253-9515
Fax
(706) 253-9516
NPI assigned
Jan 5, 2007
Last updated
Jun 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1346 GA Primary

Addresses

Primary practice location

201 Cove Rd
Jasper, GA 30143-1356

Mailing address

201 Cove Rd
Jasper, GA 30143-1356
Phone (706) 253-9515

Other identifiers 1

IdentifierTypeStateIssuer
00425092BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080822000157 GA Practitioner - Clinical Psychologist 1557436714 Practice locations: Jasper, GA; Woodstock, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

201 Cove Rd
Jasper, GA 30143-1356
Phone (706) 253-9515

8910 Main St
Woodstock, GA 30188-4916
Phone (770) 924-1818

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1346GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaplan Counseling Inc. Psychologist PastSince Oct 1, 2007 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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1477600906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431356",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431356",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "ANN",
        "middle_name": "SIDWELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "1346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00425092B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.