Angelique Laurelyn Pickett, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN186812 Issued in GA

Practice address

14 Cherokee Rd
Cedartown, GA 30125-4381

Phone

(770) 749-9600

Fax

(770) 749-9628

NPI assigned

Apr 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Angelique Laurelyn Schultz Other name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Allergy and Asthma of Georgia PCGroup PAC ID 2062460785, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Center for Allergy & Asthma of Georgia PC

  • Allergy & Immunology Physician
  • Villa Rica, GA
  • NPI 1578504536
  Medicare reassignment Care Compare group NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1467016055
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1497044184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-295-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 CHEROKEE RD",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301254381",
            "telephone_number": "770-749-9600",
            "fax_number": "770-749-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "ANGELIQUE",
        "middle_name": "LAURELYN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN186812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112877A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELIQUE",
            "last_name": "SCHULTZ",
            "middle_name": "LAURELYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather Leann Parker
• Pulin Patel, MD
• Faith Payne, LMSW
• Robert J Pezzin, M.D.
• Sterly Mary Philip, PT, DPT
• Amanda Leigh Plunkett, PHARMD
• Polk County Board of Health
• Polk County Board of Health
• Polk County Emergency Medical Service
• Polk County, Ga Board of Commissioners

• Nurse Practitioner in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.