Patricia Pack, PT

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

425 Issued in OK

Practice address

1111 N 36TH St
Muskogee, OK 74401-1809

Phone

(918) 683-4621

Fax

(918) 683-4002

NPI assigned

Aug 30, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Kelly B. Todd Cerebral Palsy & Neuromuscular Foundation, Inc

  • Developmental Disabilities Clinic/Center
  • Muskogee, OK
  • NPI 1548370711
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013027275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 60 BOX 205",
            "city": "CHECOTAH",
            "state": "OK",
            "postal_code": "744269408",
            "telephone_number": "918-473-8249",
            "fax_number": "918-683-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N 36TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011809",
            "telephone_number": "918-683-4621",
            "fax_number": "918-683-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "OK",
            "license": "425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "510163643001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth W. Owens, AU.D
• Kyle James Ozaeta
• Pace Dialysis PC (Pace Nephrology PC)
• Andreka Pace, BHRS
• Patrice Diane Pace, DO
• Judy Paden
• Sandra Paden
• Whitney Renee Padgett, A.T.C.
• Matthew Palmer III
• Ryan Dane Palmer

• Pediatric Rehabilitation Medicine Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Pediatric Rehabilitation Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.