JARED W PACK DO
NPI 1396163101
Internal Medicine in Johnson City, TN

Q: What is Jared Pack's NPI number?

The NPI number for Jared Pack is 1396163101. It was assigned to this individual provider in the NPPES registry on March 31, 2014.

Q: What is Jared Pack's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Jared Pack was last updated on December 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 March 31, 2014PECOS Enrolled

2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601(423) 434-6677(423) 461-0000 Get Directions Write a Review

NPPES record last updated: December 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 30, 2025, Nov 11, 2025, Feb 17, 2025 and 2 more (5 updates tracked since 2017).

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About Jared W Pack Do NPPES

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

JARED W PACK DO (NPI 1396163101) is an individual internal medicine provider in Johnson City, Tennessee, licensed in Tennessee (2980) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, is affiliated with Wellmont Bristol Regional Medical Center, and is a graduate of Lincoln Memorial University Medical Department (2014).

NPPES Registry Identity

NPI1396163101

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJARED W PACKCredential: DO

Location Address2408 SUSANNAH ST STE 1Johnson City, TN 37601-1765

Mailing Address2408 Susannah St Ste 1Johnson City, TN 37601-1765 · (423) 434-6677 · Fax (423) 461-0000

Phone(423) 434-6677

Fax(423) 461-0000

Sole ProprietorNo

Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2014

Enumeration DateMarch 31, 2014

Last NPPES UpdateDecember 30, 20255 updates tracked since enumeration

NPPES CertifiedDecember 30, 2025

✔ NPI 1396163101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TN · 2980

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 2980 (TN)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2408 SUSANNAH ST STE 1, Johnson City, TN 37601

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Other Identifiers 2

Medicaid1396163101VA

MedicaidQ028929TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jared W Pack Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID42587529

PECOS Enrollment IDI20170605001972

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.

Hospital Affiliations CMS Care Compare 2

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

Wellmont Bristol Regional Medical Center

Acute Care Hospitals · Bristol, TN

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440012

LocationOne Medical Park BlvdBristol, TN 37620 · Sullivan County

Emergency services Birthing friendly

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440017

Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37601 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

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Other Providers at the Same Location NPPES 11

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

EMMALEA ELIZABETH JOHNSTON NP-C

Nurse Practitioner (Family)