SHASTA PICKENS
NPI 1679297436
Nurse Practitioner - Family in Laurel, MS

Q: What is Shasta Pickens's NPI number?

The NPI number for Shasta Pickens is 1679297436. It was assigned to this individual provider in the NPPES registry on September 26, 2022.

Q: What is Shasta Pickens's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shasta Pickens was last updated on January 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 26, 2022PECOS EnrolledAccepts Medicare Assignment

117 S 11TH AVE, LAUREL, MS 39440(601) 425-3033(601) 422-0693 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 6, 2022, Sep 26, 2022 (2 updates tracked since 2022).

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About Shasta Pickens NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA PICKENS (NPI 1679297436) is an individual family provider in Laurel, Mississippi, licensed in Mississippi (907092) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1679297436

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHASTA PICKENS

Location Address117 S 11TH AVELaurel, MS 39440-4312

Mailing Address117 S 11th AveLaurel, MS 39440-4312 · (601) 425-3033

Phone(601) 425-3033

Fax(601) 422-0693

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 26, 2022

Last NPPES UpdateJanuary 14, 20252 updates tracked since enumeration

NPPES CertifiedDecember 16, 2024

✔ NPI 1679297436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 907092

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 907223 (MS)

117 S 11TH AVE, Laurel, MS 39440

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shasta Pickens is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42703274

PECOS Enrollment IDI20251204004846

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39440 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ELISA RENE HILLMAN F.N.P.

Nurse Practitioner (Family)