Individual provider Active NPI

Haley Marie Peace Pickett, PA

  • Physician Assistant
  • Longview, TX
National Provider Identifier
1689453656
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
338744 Issued in LA
Practice address
705 E Marshall Ave Ste 1002
Longview, TX 75601-5660
Phone
(903) 759-7200
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17250 TX
Physician Assistant 363A00000X 338744 LA Primary

Addresses

Primary practice location

705 E Marshall Ave Ste 1002
Longview, TX 75601-5660

Mailing address

8700 Millicent Way Apt 1505
Shreveport, LA 71115-2264
Phone (318) 344-5035

Other practice location 1

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231115003981 TX Practitioner - Physician Assistant 9133576903 Reassigns benefits to 1 organization
I20240618004335 LA Practitioner - Physician Assistant 9133576903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1501 Kings Hwy
Shreveport, LA 71103-4228

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

1602 Kings Hwy
Shreveport, LA 71103-4128
Phone (318) 675-8700

1606 Kings Hwy
Shreveport, LA 71103-4128
Phone (318) 675-6402

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
338744LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 4, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 4, 2024 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

705 E Marshall Ave
Ste 1002
Longview, TX 75601
Phone (903) 247-7700

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: hpickett346100@christushealth.direct-ci.net

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 3

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": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1689453656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 MILLICENT WAY APT 1505",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152264",
            "telephone_number": "318-344-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MARSHALL AVE STE 1002",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015660",
            "telephone_number": "903-759-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "HALEY",
        "middle_name": "MARIE PEACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17250",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "338744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.