Individual provider Active NPI

Corey Scott Pickett, DO

  • Family Medicine Physician
  • Pasco, WA
National Provider Identifier
1932620739
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61022938 Issued in WA
Practice address
9605 Sandifur Pkwy
Pasco, WA 99301-8028
Phone
(509) 942-3170
Fax
(509) 543-9795
NPI assigned
Jun 30, 2017
Last updated
Nov 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 227072 NC
Family Medicine Physician 207Q00000X OP61022938 WA Primary
General Practice Physician 208D00000X OP61022938 WA

Addresses

Primary practice location

9605 Sandifur Pkwy
Pasco, WA 99301-8028

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

800 Tilghman Dr
Dunn, NC 28334-5510
Phone (910) 892-1000 ext. 4107

Other practice location 2

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 814-8630

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL epic Health Information Exchange (HIE)
Direct Messaging Address cpickett1646116@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210810000811 WA Practitioner - Family Practice 6204259732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

9605 Sandifur Pkwy
Pasco, WA 99301-8028
Phone (509) 942-3170

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61022938WAMDGeneral Practice Physician
227072NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Aug 16, 2021 Accepting new patients
Kadlec Regional Medical Center CurrentSince Aug 16, 2021 Accepting new patients

Locations

9605 Sandifur Pkwy
Pasco, WA 99301
Phone (509) 942-3170

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

Interoperability endpoints

  • Direct secure messaging: cpickett1646116@wm.providencedirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1932620739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 SANDIFUR PKWY",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018028",
            "telephone_number": "509-942-3170",
            "fax_number": "509-543-9795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Tilghman Dr",
            "address_purpose": "LOCATION",
            "city": "Dunn",
            "state": "NC",
            "postal_code": "283345510",
            "country_code": "US",
            "telephone_number": "910-892-1000 x4107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-814-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "COREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "227072",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61022938",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "OP61022938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "epic",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpickett1646116@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9605 Sandifur Pkwy",
            "city": "Pasco",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993018028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.