Active NPI
Ronald Pack, MD
- Internal Medicine Physician
- Knoxville, TN
National Provider Identifier
1568408508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 07786
- Practice address
- 1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909-2675 - Phone
- (865) 584-4747
- Fax
- (865) 212-3718
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 07786 | TN | Primary |
Addresses
Primary practice location
1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909-2675
Mailing address
9333 Parkwest Boulevard
Knoxville, TN 37923
Phone (865) 531-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3158311 | Medicaid | TN |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07786 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, PLLC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Cool Springs Internal Medicine and Pediatrics
- Internal Medicine Physician
- Brentwood, TN
- NPI 1659090298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568408508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9333 PARKWEST BOULEVARD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37923",
"telephone_number": "865-531-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 E WEISGARBER RD STE 200",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379092675",
"telephone_number": "865-584-4747",
"fax_number": "865-212-3718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACK",
"first_name": "RONALD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "07786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3158311",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.