Individual provider Active NPI

William S Pickens, MD

  • Cardiovascular Disease Physician
  • Pensacola, FL
National Provider Identifier
1669472940
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME23808 Issued in FL
Practice address
1717 N E St
Suite 331
Pensacola, FL 32501-6339
Phone
(850) 444-1717
Fax
(850) 857-1747
NPI assigned
Jul 28, 2005
Last updated
Jun 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME23808 FL
Cardiovascular Disease Physician 207RC0000X ME7968 AL
Cardiovascular Disease Physician 207RC0000X ME23808 FL Primary

Addresses

Primary practice location

1717 N E St
Suite 331
Pensacola, FL 32501-6339

Mailing address

1717 North E Street
Suite 333
Pensacola, FL 32501
Phone (850) 444-1717

Other identifiers 2

IdentifierTypeStateIssuer
009304090MedicaidAL
0579106 00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME7968ALMDCardiovascular Disease Physician
ME23808FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Group LLC Past 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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1669472940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NORTH E STREET",
            "address_2": "SUITE 333",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-444-1717",
            "fax_number": "850-857-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N E ST",
            "address_2": "SUITE 331",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325016339",
            "telephone_number": "850-444-1717",
            "fax_number": "850-857-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME23808",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "ME7968",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME23808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009304090",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0579106 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.