JAKE PICKENS (CRNP) – Nurse Practitioner, NPI 1770351769

JAKE PICKENS (CRNP) is a healthcare provider. based in Haleyville, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-170309 (AL). The NPI Number for JAKE PICKENS (CRNP) is 1770351769

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
JAKE PICKENS (CRNP)
NPI
1770351769
Phone
(205) 485-7822
Address
1728 11TH AVE
Enumeration Date
19 December 2023
Last Update Date
12 January 2024

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Secondary Phone
2054857822
Graduation Year
2023 (3 years ago)
PAC ID
9931573052
Group Practice PAC ID
3678947793
Professional Enrollment ID
I20240328000674
Address ID
AL355651506HA1728XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for JAKE PICKENS (CRNP)

  • 1728 11TH AVE

    HALEYVILLE, AL 355651506

    Phone: (205) 485-7822

    Fax: (833) 449-4072

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $227.

Total Amount is formed as General ($227) + Research ($0) + Ownership ($0) = $227.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Novo Nordisk Inc ($47).

Total Amount

$227

General + Research + Ownership

Payments

13

Total payment records

General Amount

$227

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240328000674INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35565)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678947793View full group profile
NameSpecialtyState
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Family PracticeAL

Reviews

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Frequently asked questions

What is the 10-digit NPI for JAKE PICKENS (CRNP)?
JAKE PICKENS (CRNP) — NPI 1770351769 — is the standard way to identify this listing.
Is JAKE PICKENS (CRNP) still practicing?
JAKE PICKENS (CRNP) is currently listed as active in the public NPI registry.
What is JAKE PICKENS (CRNP)'s primary classification?
Nurse Practitioner is the headline specialty for JAKE PICKENS (CRNP) here. Clinical services aligned with this taxonomy classification.
What area does JAKE PICKENS (CRNP) serve?
JAKE PICKENS (CRNP)'s listing highlights Haleyville, Alabama; more addresses can appear in NPPES.
Why does JAKE PICKENS (CRNP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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