KOLEY CHANCE PACK
NPI 1255994836
Family Medicine in Amarillo, TX

Q: What is Koley Pack's NPI number?

The NPI number for Koley Pack is 1255994836. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Q: What is Koley Pack's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Koley Pack was last updated on September 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 18, 2019PECOS EnrolledAccepts Medicare Assignment

2001 S COULTER ST, AMARILLO, TX 79106(806) 318-5777(806) 513-6926 Get Directions Write a Review

NPPES record last updated: September 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 8, 2022, Apr 18, 2019 (2 updates tracked since 2019).

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About Koley Chance Pack NPPES

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

KOLEY CHANCE PACK (NPI 1255994836) is an individual family medicine provider in Amarillo, Texas, licensed in Texas (T8007) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1255994836

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameKOLEY CHANCE PACK

Location Address2001 S COULTER STAmarillo, TX 79106-2521

Mailing Address2001 S Coulter StAmarillo, TX 79106-2521 · (806) 318-5777 · Fax (806) 513-6926

Phone(806) 318-5777

Fax(806) 513-6926

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateApril 18, 2019

Last NPPES UpdateSeptember 8, 20222 updates tracked since enumeration

NPPES CertifiedAugust 4, 2022

✔ NPI 1255994836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · T8007

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2001 S COULTER ST, Amarillo, TX 79106

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Koley Chance Pack is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395074942

PECOS Enrollment IDI20220817001670

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.

Medicare Billing Reassignments

Medicare enrollment records show Koley Pack reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Nwtx Physician Network, PLLC

2.6 mi

Family Medicine

2505 LAKEVIEW DR, SUITE 205
Amarillo, TX 79109

Reassigned Medicare billing, Texas enrollment
44 clinicians in this Medicare group

NPI 1790109916 (806) 803-9552

Moore County Hospital District

47 mi

Critical Access

224 E 2ND ST
Dumas, TX 79029

Reassigned Medicare billing, Texas enrollment
92 clinicians in this Medicare group

NPI 1700991700 (806) 935-7171

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

99 services73 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

61 services38 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

41 services30 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

18 services13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

15 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Critical Access Hospitals · Dumas, TX

OwnershipGovernment - Hospital District or Authority

CMS Certification Number451386

Location224 E Second StreetDumas, TX 79029 · Moore County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NUMBER ONE CARE PA

Physical Medicine & Rehabilitation

2001 S COULTER ST
AMARILLO, TX 79106

Potter County (806) 351-2273

SHONDA SCHOON FNP

Clinical Nurse Specialist (Family Health)

2001 S COULTER ST, 2001 S COULTER ST.
AMARILLO, TX 79106

Potter County (806) 350-7918

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 Koley Pack's NPI number?

The NPI number for Koley Pack is 1255994836. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Where is Koley Pack located?

Koley Pack practices at 2001 S Coulter St, Amarillo, TX 79106. The listed phone number is (806) 318-5777.

What is Koley Pack's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Koley Pack enrolled in Medicare?

Yes. Koley Pack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Koley Pack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Koley Pack reassigns Medicare benefits to 2 organizations: Nwtx Physician Network, PLLC (Amarillo, TX) and Moore County Hospital District (Dumas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Koley Pack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Koley Pack accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Koley Pack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Koley Pack affiliated with any hospitals?

According to CMS data, Koley Pack is affiliated with Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Koley Pack was last updated on September 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.