Individual provider Active NPI

Steven Henry Pack, PA

  • Physician Assistant
  • Lebanon, TN
National Provider Identifier
1346351194
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA626 Issued in TN
Practice address
201 Signature PL Ste 103
Lebanon, TN 37087-3377
Phone
(615) 257-7778
Fax
(615) 235-3660
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA626 TN Primary

Addresses

Primary practice location

201 Signature PL Ste 103
Lebanon, TN 37087-3377

Mailing address

201 Signature PL Ste 103
Lebanon, TN 37087-3377
Phone (615) 257-7778

Other identifiers 1

IdentifierTypeStateIssuer
3662285MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614001371 TN Practitioner - Physician Assistant 7517941065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jantz Family Practice PLLCGroup PAC ID 6901210749, 5 clinicians

Practice addresses (Care Compare)

201 Signature PL
Suite 103
Lebanon, TN 37087-3377
Phone (615) 257-7778

Hospital & facility affiliations

  • Homefirst of Middle Tennessee, LLC Home health agency, Nashville, TN, CCN 447578
  • Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581
  • Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150
  • Vanderbilt Wilson County Hospital Hospital, Lebanon, TN, CCN 440193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA626TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Cardiology Consultants, PC Past Accepting new patients
Tennessee Em-I Medical Services PC Physician Assistant Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1346351194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIGNATURE PL STE 103",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873377",
            "telephone_number": "615-257-7778",
            "fax_number": "615-235-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIGNATURE PL STE 103",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873377",
            "telephone_number": "615-257-7778",
            "fax_number": "615-235-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "STEVEN",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3662285",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.