Heather Rene Pickett, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10903589-1204 Issued in UT

Practice address

360 S 1300 W
Pleasant Grove, UT 84062-3761

Phone

(385) 440-1400

Fax

(801) 845-9965

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 4, 2018 through Sep 4, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1982688735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S 1300 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623761",
            "telephone_number": "385-440-1400",
            "fax_number": "801-845-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S 1300 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623761",
            "telephone_number": "385-440-1400",
            "fax_number": "801-845-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 W Losey St",
            "address_purpose": "LOCATION",
            "city": "Scott AFB",
            "state": "IL",
            "postal_code": "622255250",
            "country_code": "US",
            "telephone_number": "618-256-6267",
            "fax_number": "618-256-7931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "HEATHER",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111670",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10903589-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Mashae Petersen, PMHNP
• Cassandra Peterson
• Janae Peterson, ACMHC
• Rebekah Kay Peterson, LCSW
• Sophia Christina Pickering
• Mike J Pickett, CSW
• Melissa Pierce
• Sharrai Janae Pifer
• Piinnacle Dental Parrtners
• Natalie E Pitts, RBT

• Family Medicine Physician in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.