Colin Packard

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

95541 Issued in GA

Practice address

1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605

Phone

(937) 409-5282

NPI assigned

Mar 21, 2020

Sex

Male

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Scottish Rite Children'S Medical Center

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1184779332
  NPD (past)
• Scottish Rite Childrens Medical Ctr

  • Children's Hospital
  • Atlanta, GA
  • NPI 1922178789
  NPD (past)

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1629604608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 WILMER ST NE UNIT 1226",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303083027",
            "telephone_number": "937-409-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "937-409-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "COLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-21",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "95541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lidya Pacheco-Carpenter
• Sean Christopher Pacheco, PA-C
• Pacific Coast Medical Group Company
• Pacific Health Solutions, Inc.
• Roberto Pacifici, M.D.
• Grace A Packard
• Jennifer Packard, LCSW
• Jillian Marie Packer, PHARMD, BCPPS
• Julia Michelle Packer, LMSW, MPH
• Pad Specialists - Atlanta LLC

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.