Curtis Brent Pack, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1450 Issued in WV

Practice address

503 Roosevelt Blvd
Eleanor, WV 25070

Phone

(304) 586-0001

Fax

(304) 586-0079

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/49/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Point Pleasant Physician Billing Services

  • Multi-Specialty Clinic/Center
  • PT Pleasant, WV
  • NPI 1396798898
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1013016849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD STE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609816",
            "telephone_number": "304-757-6999",
            "fax_number": "304-757-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 ROOSEVELT BLVD",
            "city": "ELEANOR",
            "state": "WV",
            "postal_code": "25070",
            "telephone_number": "304-586-0001",
            "fax_number": "304-586-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "CURTIS",
        "middle_name": "BRENT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL INSURANCE",
            "identifier": "550737600",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001721667",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "550737600",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0245176",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046893000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "385750",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Johnston
• Linda L Kessinger, MD
• Khristina L Light
• Dillon Gene Lowery
• Stephanie Dawn Metz, FNP-BC
• Louise A Papciak
• Kevin Robert Parker, RPH
• Larry Phillips, LPN
• Amanda Dawn Priddy, PHARM.D.
• William Dean Rollyson, MD

• Family Medicine Physician in Eleanor, WV
• Providers in Eleanor, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.