Whitney W Pack, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

48986 Issued in CO

Practice address

1199 Main Ave
Suite 205
Durango, CO 81301-5259

Phone

(970) 259-7337

Fax

(970) 259-7366

NPI assigned

Jul 15, 2007

Last updated

Jul 6, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 31, 2017 through Aug 31, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1114126679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 MAIN AVE",
            "address_2": "SUITE 205",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015259",
            "telephone_number": "970-259-7337",
            "fax_number": "970-259-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 MAIN AVE",
            "address_2": "SUITE 205",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015259",
            "telephone_number": "970-259-7337",
            "fax_number": "970-259-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "WHITNEY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-15",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "48986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Outenreath, PHD, MD
• Steven P Owen, D.D.S.
• Adam Owens, M.D.
• Ronald T. Owens, D.D.S.
• Ross Clark Owens, DDS
• Ethan Paddock, MD
• Michael Hurd Paine, MD
• Mareca Denali Pallister, M.D.
• Carin L Palmer
• Deidree Gail Palmer, CNMT

• Pediatrics Physician in Durango, CO
• Providers in Durango, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.