Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jared W Pack, DO

Individual provider Internal Medicine Physician · NPI 1396163101

Jared W Pack, DO is an Internal Medicine in Johnson City, Tennessee. Graduated from Lincoln Memorial University Medical Department in 2014, 12 years ago. Practices with East Tennessee Recovery PLLC, a 19-clinician group. Licensed in Tennessee.

Years since qualifying
12
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN
In the registry since
2014
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone: (423) 434-6677
Fax: (423) 461-0000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2980 (TN)
Hospitalist Physician Taxonomy 208M00000X · Licence 2980 (TN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396163101
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 31, 2014
Last updated in NPPESDecember 30, 2025
Certification dateDecember 30, 2025
Mailing address2408 Susannah St Ste 1, Johnson City, TN 37601-1765

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2014 (12 years in practice)
Group practice East Tennessee Recovery Pllc — 19 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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