KELLIE PACK NP
NPI 1336542943
Nurse Practitioner - Family in Jasper, GA

NPI Status: Active since September 27, 2014

Contact Information

220 J L WHITE DR
SUITE 120
JASPER, GA
ZIP 30143
Phone: (706) 692-3539

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  • Individual
  • Female
  • Years of Experience 12
  • Nurse Practitioner
  • Family
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About KELLIE PACK

This page provides the complete NPI Profile along with additional information for Kellie Pack, a provider established in Jasper, Georgia with a medical specialization in Nurse Practitioner, focusing in family and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1336542943 assigned on September 2014. The practitioner's primary taxonomy code is 363LF0000X with license number RN197369 (GA). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1336542943
Provider Name
KELLIE PACK NP
Gender
Female
Entity Type
Individual
Location Address
220 J L WHITE DR SUITE 120 JASPER, GA 30143
Location Phone
(706) 692-3539
Mailing Address
220 J L WHITE DR SUITE 120 JASPER, GA 30143
Mailing Phone
(706) 692-3539
Medical School Name
OTHER
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
09-27-2014
Last Update Date
09-27-2014
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A nurse practitioner (NP) like Kellie Pack is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
RN197369
License State
GA

Medicare Participation & PECOS Enrollment Status

Kellie Pack is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kellie Pack is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4486979531

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20150211002124

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.8 for a new patient copayment and $23.71 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30143 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $83.23
  • Minimum New Patient Price $53.31
  • Maximum New Patient Price $164.04
  • Average New Patient Copayment $20.8
  • Minimum New Patient Copayment $13.32
  • Maximum New Patient Copayment $41.01

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.84
  • Minimum Established Patient Price $16.68
  • Maximum Established Patient Price $133.24
  • Average Established Patient Copayment $23.71
  • Minimum Established Patient Copayment $4.17
  • Maximum Established Patient Copayment $33.31

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care Plan 16% 31
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Colorectal Cancer Screening 68% 25
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Pneumococcal Vaccination Status for Older Adults 61% 31
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 81% 43
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 3% 36
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Screening for Osteoporosis for Women Aged 65-85 Years of Age 61% 31
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

Reviews for KELLIE PACK NP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1336542943
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2366104498
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 1 + 0 + 4 + 4 + 9 + 8 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1336542943 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 13 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1144201781 JASON ANDREW BERNER M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)220 J L WHITE DR SUITE 110
JASPER, GA 30143
(706) 253-3842
1588759336CARDIAC DISEASE SPECIALISTS, PC
Organization
Internal Medicine (Cardiovascular Disease)220 J L WHITE DR STE 100
JASPER, GA 30143
(706) 253-8001
1962572875MRS. SARA L WILLIAMS FNP C
Individual
Nurse Practitioner (Family)220 J L WHITE DR SUITE 100
JASPER, GA 30143
(706) 253-8001
1972701936DR. MARK ANDREW SUPAN M.D.
Individual
Obstetrics & Gynecology220 J L WHITE DR SUITE 120
JASPER, GA 30143
(706) 635-3539
1457517146 WANDA DENISE CORREIA F.N.P.
Individual
Nurse Practitioner (Family)220 J L WHITE DR SUITE 110
JASPER, GA 30143
(706) 253-3842
1235354424GEORGIA UROLOGY PA
Organization
Urology220 J L WHITE DR SUITE 160
JASPER, GA 30143
(706) 692-4384
1649264177DR. VINCENT G MOLINARI MD
Individual
Obstetrics & Gynecology220 J L WHITE DR SUITE 120
JASPER, GA 30143
(706) 692-3539
1346204062 SANJAY SERRAO MD
Individual
Internal Medicine220 J L WHITE DR STE 150
JASPER, GA 30143
(706) 299-2200
1548265838 WALTER KENNETH AUSTIN JR. MD
Individual
Internal Medicine220 J L WHITE DR SUITE 100
JASPER, GA 30143
(706) 636-6500
1225253842WOMENS SPECIALTY CENTER OF NORTH GEORGIA
Organization
Obstetrics & Gynecology (Hospice and Palliative Medicine)220 J L WHITE DR SUITE 120
JASPER, GA 30143
(706) 692-3539
1417051590 JOEL A ROSENFELD M.D.
Individual
Urology220 J L WHITE DR SUITE 160
JASPER, GA 30143
(706) 692-4384
1518963388DR. ROBERTO F PEREIRA M.D.
Individual
Internal Medicine (Cardiovascular Disease)220 J L WHITE DR SUITE 100
JASPER, GA 30143
(706) 253-8001
1639466287MRS. TANSY RIDINGS PA-C
Individual
Physician Assistant220 J L WHITE DR SUITE 160
JASPER, GA 30143
(706) 692-4384

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336542943, enumerated in the NPI registry as an "individual" on September 27, 2014

The provider is located at 220 J L White Dr Suite 120 Jasper, Ga 30143 and the phone number is (706) 692-3539

The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family

The provider has more than 12 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $83.23 with an average copayment of $20.8 for new patient appointments. Established patients should expect a typical charge of $94.84 and an average copayment of 23.71. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on September 27, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.