Jake Pickens, CRNP in Haleyville, AL - Medicare Nurse Practitioner

Jake Pickens, CRNP is a medicare enrolled "Nurse Practitioner" in Haleyville, Alabama. His current practice location is 1728 11th Ave, Haleyville, Alabama. You can reach out to his office (for appointments etc.) via phone at (205) 485-7822.

Jake Pickens is licensed to practice in Alabama (license number 1-170309) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770351769.

Contact Information

	Jake Pickens, CRNP
	1728 11th Ave, Haleyville, AL 35565-1506
	(205) 485-7822
	(833) 449-4072

Map and Direction

Provider's Profile

Full Name	Jake Pickens
Gender	Male
Speciality	Nurse Practitioner
Location	1728 11th Ave, Haleyville, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770351769
Provider Enumeration Date: 12/19/2023
Last Update Date: 01/12/2024

Medicare PECOS Information:

PECOS PAC ID: 9931573052
Enrollment ID: I20240328000674

Medical Identifiers

Medical identifiers for Jake Pickens such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770351769	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WE0003X	Registered Nurse - Emergency	1-170309 (Alabama)	Secondary
363L00000X	Nurse Practitioner	1-170309 (Alabama)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jake Pickens allows following entities to bill medicare on his behalf.

Entity Name	Revive Medical Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740996636 PECOS PAC ID: 3678947793 Enrollment ID: O20230313001344

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jake Pickens is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jake Pickens, CRNP 1728 11th Ave, Haleyville, AL 35565-1506 Ph: (205) 485-7822	Jake Pickens, CRNP 1728 11th Ave, Haleyville, AL 35565-1506 Ph: (205) 485-7822

Reviews and Comments

Nurse Practitioner Nurses in Haleyville, AL

Rebekah Seales, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 42030 Highway 195, Haleyville, AL 35565 Phone: 205-485-7288
Allison Clark, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 42320 Highway 195, Haleyville, AL 35565 Phone: 205-486-8899 Fax: 205-486-8908
Mrs. Layla L Raper, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 904 26th St, Haleyville, AL 35565 Phone: 205-486-5234 Fax: 205-486-5232
Brandy Hyde, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 42320 Highway 195, Haleyville, AL 35565 Phone: 205-486-8899 Fax: 205-486-8908
Ms. Nikki Lashelle Burleson, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 42320 Highway 195, Haleyville, AL 35565 Phone: 205-486-8899 Fax: 205-486-8908
Laura B Williams, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 525 Layne Hill Drive, Haleyville, AL 35565 Phone: 205-486-5234 Fax: 205-486-5232
Jessica Loraine Hammonds, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3412 Oakhaven Cir, Haleyville, AL 35565 Phone: 205-485-4385

Jake Pickens, CRNP - Medicare Nurse Practitioner in Haleyville, AL