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MR. JAMES WALTER PACK PA
NPI 1164564811
Physician Assistant - Surgical in Millersville, MD

Active since February 12, 2007PECOS Enrolled
750 OAKWILDE CT, MILLERSVILLE, MD 21108(410) 987-9110 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. James Walter Pack Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JAMES WALTER PACK PA (NPI 1164564811) is an individual surgical provider in Millersville, Maryland, licensed in Maryland (C0001314) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164564811
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. JAMES WALTER PACKCredential: PA
Location Address750 OAKWILDE CTMillersville, MD 21108-1447
Mailing Address750 Oakwilde Ct.Millersville, MD 21108 · (410) 987-9110
Phone(410) 987-9110
Sole ProprietorYes
Enumeration DateFebruary 12, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1164564811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in MD · C0001314
750 OAKWILDE CT, Millersville, MD 21108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. James Walter Pack Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Pack's NPI number?

The NPI number for James Pack is 1164564811. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Where is James Pack located?

James Pack practices at 750 Oakwilde Ct, Millersville, MD 21108. The listed phone number is (410) 987-9110.

What is James Pack's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is James Pack enrolled in Medicare?

Yes. James Pack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for James Pack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.