Active NPI
Billie Candice Pack, D.O.
- Physical Medicine & Rehabilitation Physician
- Durham, NC
National Provider Identifier
1487629739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 2011-01899
- Practice address
- 4230 N Roxboro St
Durham, NC 27704-1826 - Phone
- (919) 477-9805
- NPI assigned
- Feb 21, 2006
- Last updated
- Mar 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OS012220 | PA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | N2226 | TX | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 2011-01899 | NC | Primary |
Addresses
Primary practice location
4230 N Roxboro St
Durham, NC 27704-1826
Mailing address
9 Crestmont CT.
Durham, NC 27703-9480
Phone (412) 657-5245
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001894130 | Medicaid | PA | |
| 613851 | Other | TX | MEDICARE PTAN |
| NC47140281 | Other | NC | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS012220 | PA | MD | Specialist |
| N2226 | TX | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330905600000",
"number": "1487629739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CRESTMONT CT.",
"city": "DURHAM",
"state": "NC",
"postal_code": "277039480",
"telephone_number": "412-657-5245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041826",
"telephone_number": "919-477-9805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACK",
"first_name": "BILLIE",
"middle_name": "CANDICE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2012-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "OS012220",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "TX",
"license": "N2226",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NC",
"license": "2011-01899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001894130",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "613851",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "NC47140281",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.