Kellie Pack, NP - Medicare Nurse Practitioner in Jasper, GA

Kellie Pack, NP is a medicare enrolled "Nurse Practitioner - Family" in Jasper, Georgia. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Northside Surgical Professional Services Llc and her current practice location is 220 J L White Dr, Suite 120, Jasper, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 692-3539.

Kellie Pack is licensed to practice in Georgia (license number RN197369) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336542943.

Contact Information

Kellie Pack, NP
220 J L White Dr, Suite 120,
Jasper, GA 30143-4893
(706) 692-3539
Not Available

Map and Direction




Provider's Profile

Full NameKellie Pack
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location220 J L White Dr, Jasper, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kellie Pack graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1336542943
  • Provider Enumeration Date: 09/27/2014
  • Last Update Date: 09/27/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 4486979531
  • Enrollment ID: I20150211002124

Medical Identifiers

Medical identifiers for Kellie Pack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336542943NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family RN197369 (Georgia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northside Surgical Professional Services Llc8628253424272

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. Kellie Pack allows following entities to bill medicare on her behalf.
Entity NameNorthside Surgical Professional Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356630990
PECOS PAC ID: 8628253424
Enrollment ID: O20110420000598

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. Kellie 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 AddressPractice Location Address
Kellie Pack, NP
220 J L White Dr, Suite 120,
Jasper, GA 30143-4893

Ph: (706) 692-3539
Kellie Pack, NP
220 J L White Dr, Suite 120,
Jasper, GA 30143-4893

Ph: (706) 692-3539

Reviews and Comments


Nurse Practitioner Nurses in Jasper, GA

Trang Mai Nguyen, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1020 J L White Dr, Suite 110a, Jasper, GA 30143
Phone: 706-299-2220    
Maura Heath, FNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 542 Moorings Run, Jasper, GA 30143
Phone: 404-775-1283    
Kimberly New Parker, FNP, RN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 51 Gordon Rd, Jasper, GA 30143
Phone: 706-692-9768    
Brooke B Childers, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 220 J L White Dr Ste 120, Jasper, GA 30143
Phone: 706-692-3539    
Julie Freeman,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1245 Noah Dr, Jasper, GA 30143
Phone: 706-253-1954    
Kristen Elizabeth Cornelius, MSN, AG-ACNP, CV-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 49 Gordon Road Ste 101, Jasper, GA 30143
Phone: 678-513-2273    Fax: 678-513-8869
Ashley Gilley,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 744 Noah Dr Ste 108, Jasper, GA 30143
Phone: 706-253-2828    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.