Individual provider Active NPI

Brenna Pickard, D.O.

  • Hospitalist Physician
  • Fort Worth, TX
National Provider Identifier
1861819351
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
R1615 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-1475
NPI assigned
Mar 24, 2014
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X R1615 TX
Hospitalist Physician 208M00000X R1615 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpickard136328@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170509000969 TX Practitioner - Pediatric MedicinePractitioner - Hospitalist 4688951262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hospitalist
Education
University of North Texas HSC, College of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook Childrens Physician NetworkGroup PAC ID 7719884584, 307 clinicians

Practice addresses (Care Compare)

2530 Scripture St
Denton, TX 76201-4317
Phone (940) 243-0104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1615TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics CurrentSince Oct 28, 2019 Accepting new patients
Acs Primary Care Physicians Southwest, PA Hospitalist CurrentSince Jun 1, 2018 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Oct 28, 2019 Accepting new patients
Cook Children's Medical Center Past Accepting new patients
Cook Children's Medical Center Past Accepting new patients

Locations

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

2530 Scripture St
Denton, TX 76201
Phone (940) 243-0104

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

2555 Gulf Fwy S
League City, TX 77573
Phone (832) 932-9850

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: bpickard136328@cookchildrens.direct-ci.com

Organizations & group practices 5

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1861819351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD",
        "first_name": "BRENNA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2021-04-09",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R1615",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R1615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpickard136328@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.