Megan G Pack

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

525 NW Lake Whitney PL Ste 102
Port St Lucie, FL 34986-1605

Phone

(772) 337-8164

NPI assigned

Oct 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Megan G Reeves Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1831601871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BLUE HERON LN",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349828049",
            "telephone_number": "772-332-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 NW LAKE WHITNEY PL STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861605",
            "telephone_number": "772-337-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "MEGAN",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "REEVES",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Case Manager/Care Coordinator in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.