Active NPI
Amy Clare Pickard, PA-C
- Physician Assistant
- Killeen, TX
National Provider Identifier
1760815955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11604
- Practice address
- 3801 Scott and White Dr
Killeen, TX 76543-5252 - Phone
- (254) 680-1100
- Fax
- (254) 699-3835
- NPI assigned
- Aug 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2013-0042 | NM | |
| Physician Assistant | 363A00000X | PA.1156 | AL | |
| Physician Assistant | 363A00000X | PA11604 | TX | Primary |
Addresses
Primary practice location
3801 Scott and White Dr
Killeen, TX 76543-5252
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other names 1
- Amy Clare Lalla
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.1156 | AL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GK Healthcare Solutions, LLC | Physician Assistant | Current | Accepting new patients |
| Signify Health, LLC | Physician Assistant | Current | Accepting new patients |
Locations
4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280
1900 International Park Dr
Ste 140
Birmingham, AL 35243
Phone (615) 977-9107
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- apickard299709@direct.sw.org
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1760815955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 SCOTT AND WHITE DR",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765435252",
"telephone_number": "254-680-1100",
"fax_number": "254-699-3835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKARD",
"first_name": "AMY",
"middle_name": "CLARE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-12",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2013-0042",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AL",
"license": "PA.1156",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA11604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "LALLA",
"middle_name": "CLARE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.