Jared W Pack, DO - Medicare Internal Medicine in Johnson City, TN

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Jared W Pack, DO is a medicare enrolled "Internal Medicine" physician in Johnson City, Tennessee. He went to Lincoln Memorial University Medical Department and graduated in 2014 and has 11 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice State Of Franklin Healthcare Associates, Pllc, New Life Medicine and his current practice location is 2408 Susannah St, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 434-6677.

Jared W Pack is licensed to practice in Tennessee (license number 2980) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1396163101.

Contact Information

Jared W Pack, DO
2408 Susannah St,
Johnson City, TN 37601-1732
(423) 434-6677
Not Available

Map and Direction




Physician's Profile

Full NameJared W Pack
GenderMale
SpecialityInternal Medicine
Experience11 Years
Location2408 Susannah St, Johnson City, Tennessee
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jared W Pack attended and graduated from Lincoln Memorial University Medical Department in 2014
  NPI Data:
  • NPI Number: 1396163101
  • Provider Enumeration Date: 03/31/2014
  • Last Update Date: 11/11/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0042587529
  • Enrollment ID: I20170605001972

Medical Identifiers

Medical identifiers for Jared W Pack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396163101NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 2980 (Tennessee)Primary
208M00000XHospitalist 2980 (Tennessee)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Wellmont Holston Valley Medical CenterKingsport, TNHospital
Wellmont Bristol Regional Medical CenterBristol, TNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
State Of Franklin Healthcare Associates, Pllc2466346291263
New Life Medicine943643490917

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. Jared W Pack allows following entities to bill medicare on his behalf.
Entity NameState Of Franklin Healthcare Associates, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063459410
PECOS PAC ID: 2466346291
Enrollment ID: O20040211001101
Entity NameWellmont Medical Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780986257
PECOS PAC ID: 8123291739
Enrollment ID: O20111026000909
Entity NameNew Life Medicine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114462215
PECOS PAC ID: 9436434909
Enrollment ID: O20170323002169

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. Jared W 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
Jared W Pack, DO
2408 Susannah St,
Johnson City, TN 37601-1732

Ph: () -		Jared W Pack, DO
2408 Susannah St,
Johnson City, TN 37601-1732

Ph: (423) 434-6677

Reviews and Comments


Internal Medicine Doctors in Johnson City, TN

Dr. Alan Cox, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2603 Avondale Dr, Johnson City, TN 37604
Phone: 423-767-8268    
Dr. Sheeba Anand, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 325 N State Of Franklin, Johnson City, TN 37614
Phone: 423-439-6283    
Dr. Charles Famoyin, M.D.
Internal Medicine
Medicare: May Accept Medicare Assignments
Practice Location: 302 Wesley St, Suite 3, Johnson City, TN 37601
Phone: 423-282-0561    Fax: 423-268-2674
Dr. Tariq Ziad Haddadin, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 701 N State Of Franklin Rd Ste 2, Johnson City, TN 37604
Phone: 423-926-4468    Fax: 423-928-4838
Timothy O Mcbride, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 401 E Main St, Johnson City, TN 37601
Phone: 423-929-2584    Fax: 423-722-2060
Dr. Joe Rupe, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 301 Med Tech Pkwy Ste 240, Johnson City, TN 37604
Phone: 423-794-5520    Fax: 423-282-6940
John M Daniel, DO
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 400 N. State Of Franklin Rd., Johnson City, TN 37614
Phone: 423-282-1480    Fax: 423-928-1353

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.