Angela J Pack, MSW, LCSW, RPT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2179-C Issued in AR

Practice address

16 Pinecrest CT
Conway, AR 72032-8866

Phone

(501) 269-0679

NPI assigned

Dec 5, 2007

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 names 1

• Angela J Gore Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Geode Health of Texas, PLLCGroup PAC ID 2062896897, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.pack.1@25899.direct.athenahealth.com

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.

• Geode Health of Texas, PLLC

  • Psychiatry Physician
  • Allen, TX
  • NPI 1851037162
  Medicare reassignment Care Compare group NPD
• BSW Geode Clinicians of Texas PLLC

  • Psychiatry Physician
  • Allen, TX
  • NPI 1790482834
  Medicare reassignment NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1952584591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PINECREST CT",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720328866",
            "telephone_number": "501-269-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PINECREST CT",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720328866",
            "telephone_number": "501-269-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "ANGELA",
        "middle_name": "J",
        "credential": "MSW, LCSW, RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2179-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "GORE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Macey Oxner, BT
• Ozark Express Care of Conway, PLLC
• Ozark Revenue Group LLC
• Linda M. Pabin, RN, IBCLC
• Emory Pace, RECOVERY ASSISTANT
• Tresvil Gerard Pack, PH.D., CRC, LPC
• Pamela L. Padgett, CRNA
• Lori Page, BCBA
• Pain Treatment Centers of America, PLLC
• Amanda Grace Painter

• Clinical Social Worker in Conway, AR
• Providers in Conway, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.