Kellie Pack, NP
NPI 1336542943ActiveIndividual· Nurse Practitioner, Family· Jasper, GA
Nurse Practitioner, Family (NP) with Northside Surgical Professional Services LLC, practicing in Jasper, Georgia. In 2024 Medicare paid $2,783 for 38 patients, and Part D covered 99 of their prescriptions, 88% of them generic. Mayne Pharma Commercial LLC was the largest of 10 companies reporting payments in 2025, $620.66 in all, mostly food and beverage. Lists Northside Hospital Cherokee as a hospital affiliation.
Overview
| NPI | 1336542943 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NP |
| Sole proprietor | No |
| NPI issued | Sep 27, 2014 |
| Last updated in NPPES | Sep 27, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | RN197369 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (GA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 38 |
|---|---|
| Services billed | 56 across 9 procedure codes |
| Paid by Medicare | $2,783 |
Part D prescriptions in 2024
| Prescriptions (claims) | 99 · 159 30-day fills |
|---|---|
| Patients | 38 |
| Total drug cost | $3,301 |
| Generic share | 88% of claims |
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Northside Surgical Professional Services LLCAtlanta, GA · 364 clinicians
Hospital affiliation
- Northside Hospital CherokeeCanton, GA
Industry payments (Open Payments)
- 2025$620.66 · 32 payments from 10 companies
- 2024$361.34 · 17 payments from 8 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Mayne Pharma Commercial LLC | $159.21 | 13 |
| Medtronic, Inc. | $102.95 | 1 |
| Biogen, Inc. | $84.91 | 3 |
| Organon LLC | $83.54 | 4 |
| Astellas Pharma US Inc | $82.21 | 4 |
What the 2025 payments were for
- Food and Beverage$620.66 · 32 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 38 family nurse practitioners in Jasper · All family nurse practitioners in Georgia