Amanda Pack, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.019584 Issued in OH

Practice address

141 Columbus Rd
Athens, OH 45701-1315

Phone

(740) 592-4229

Fax

(740) 592-4232

NPI assigned

Aug 2, 2016

Last updated

Aug 2, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrated Services for Behavioral HealthGroup PAC ID 9234372525, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

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.

• Integrated Services for Behavioral Health

  • Clinical Social Worker
  • Nelsonville, OH
  • NPI 1073578431
  Medicare reassignment Care Compare group NPD
• Integrated Services for Behavioral Health

  • Community/Behavioral Health Agency
  • Nelsonville, OH
  • NPI 1205196201
  NPD (past)

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1609329085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 COLUMBUS RD",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011315",
            "telephone_number": "740-592-4229",
            "fax_number": "740-592-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COLUMBUS RD",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011315",
            "telephone_number": "740-592-4229",
            "fax_number": "740-592-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.019584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Sarno Owens, PH.D.
• Stephen Jerome Owens, PH.D., ABPP
• Mackenzie Owings
• Richard R Ozmun, PT
• Whitley Pacino
• Tiffany Pack
• Claressa L Page
• Seth Dalton Page
• Tamela Page
• Andrew S Palko, ATC

• Family Nurse Practitioner in Athens, OH
• Providers in Athens, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.