Whitney Childs Pack, CPNP-AC is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Fort Worth, Texas. Her current practice location is
801 7th Ave, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at
(682) 885-3817.
Whitney Childs Pack is licensed to practice in Texas (license number 1020646) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1396401030.
Physician's Profile
| Full Name | Whitney Childs Pack |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 801 7th Ave, Fort Worth, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1396401030
- Provider Enumeration Date: 11/16/2021
- Last Update Date: 01/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 0446793921
- Enrollment ID: I20240625002936
Medical Identifiers
Medical identifiers for Whitney Childs Pack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1396401030 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 1020646 (Texas) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 1020646 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Whitney Childs Pack allows following entities to bill medicare on her behalf.
| Entity Name | Cook Childrens Physician Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750369203
PECOS PAC ID: 7719884584
Enrollment ID: O20040128000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Whitney Childs Pack is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Whitney Childs Pack, CPNP-AC
Po Box 733784,
Dallas, TX 75373-3784
Ph: (682) 885-6483 | Whitney Childs Pack, CPNP-AC
801 7th Ave,
Fort Worth, TX 76104-2733
Ph: (682) 885-3817 |
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