Individual provider Active NPI

Beth Anne Pickens, CPNP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1710937289
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001328A Issued in IN
Practice address
1633 N Capitol Ave Ste 236
Indianapolis, IN 46202-1262
Phone
(317) 962-8067
Fax
(317) 963-5038
NPI assigned
May 12, 2006
Last updated
May 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001328A IN Primary

Addresses

Primary practice location

1633 N Capitol Ave Ste 236
Indianapolis, IN 46202-1262

Mailing address

3401 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 781-4900

Other identifiers 1

IdentifierTypeStateIssuer
200441790MedicaidIN

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001328AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthnet, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: beth.adkins@hn.eclinicaldirectplus.com

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1710937289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 E RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462034744",
            "telephone_number": "317-781-4900",
            "fax_number": "317-781-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 N CAPITOL AVE STE 236",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021262",
            "telephone_number": "317-962-8067",
            "fax_number": "317-963-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001328A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200441790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.