Individual provider Active NPI

Darla J Pickett, PAC

  • Medical Physician Assistant
  • Vanceburg, KY
National Provider Identifier
1780657015
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA836 Issued in KY
Practice address
RR 3
Vanceburg, KY 41179-9701
Phone
(606) 796-3029
Fax
(606) 796-6221
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA836 KY Primary

Addresses

Primary practice location

RR 3
Vanceburg, KY 41179-9701

Mailing address

PO Box 550
Vanceburg, KY 41179-0550
Phone (606) 796-3029

Other identifiers 1

IdentifierTypeStateIssuer
9500426300MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20130701000287 TN Order and Referring Only - Physician Assistant 2769466697

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2188TNMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1780657015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411799701",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "DARLA",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500426300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vanceburg, KY

Sources for this page

Verify at the official NPI Registry.