DR. JIM PANG JR. (NPI# 1780690230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780690230 |
| Entity Type | Individual |
| Full Name | DR. JIM PANG JR. |
| Credential | M.D. |
| Practice Address |
65 Germantown Ct Ste 402 Cordova TN 38018-7290 |
| Practice Telephone | 9017524900 |
| Practice Fax Number | 9017524902 |
| Mailing Telephone | 9017524900 |
| Mailing Fax Number | 9017524902 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-02-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
14059 | MS | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
C-5226 | AR | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
017659 | TN | Allopathic & Osteopathic Physicians |
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
2006031057 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS PROVIDER NUMBE | 0063427 | 01 |
| AR | 127994001 | 05 | |
| MS | 00115350 | 05 | |
| TN | 3024414 | 05 | |
| MS | 02850722 | 05 | |
| MO | 207980814 | 05 |
| Street Address |
65 GERMANTOWN CT STE 402 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-7290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154809796 | Avery Lynette Dale | Registered Nurse | 65 Germantown Ct Ste 402, Cordova, TN 38018-4275 | 2018-08-06 |
| 1447620901 | Jim Pang Md Pllc | Clinic/Center | 65 Germantown Ct Ste 402, Cordova, TN 38018 | 2015-09-28 |
| 1255405353 | Angie D Hicks-master | Nurse Practitioner | 65 Germantown Ct Ste 402, Cordova, TN 38018-4275 | 2006-11-20 |
| 1851482921 | Tanci Chariess Burrow | Nurse Practitioner | 65 Germantown Ct Ste 402, Cordova, TN 38018 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913345 | Providence Psychiatric Services Pllc | Psychiatry & Neurology | 86 Timber Creek Dr Ste 3, Cordova, TN 38018-4284 | 2020-08-18 |
| 1205300852 | Pain Management Centers of America, Psc | Psychiatry & Neurology | 8000 Centerview Pkwy Ste 100, Cordova, TN 38018-4289 | 2019-01-16 |
| 1447530530 | Precision Mental Health, LLC | Psychiatry & Neurology | 1175 Vickery Ln, 100, Cordova, TN 38016-0682 | 2011-08-22 |
| 1497966469 | Shubi Razdan Mukatira | Psychiatry & Neurology | 8336 Macon Rd, Cordova, TN 38018-8554 | 2007-05-24 |
| 1417168386 | Healthquest | Psychiatry & Neurology | 58 Timber Creek, Cordova, TN 38016 | 2007-05-24 |
| 1316154792 | Zhiqiang Sun | Psychiatry & Neurology | 65 Germantown Ct Ste 210, Cordova, TN 38018 | 2007-05-17 |
| 1639295272 | Audria Kaye Black | Psychiatry & Neurology | 8000 Centerview Parkway, Ste 104, Cordova, TN 38018 | 2007-03-22 |
| 1235247958 | Usha B Swamy | Psychiatry & Neurology | 1176 Vickery Ln Ste 100, Cordova, TN 38016 | 2006-08-25 |
| 1831115419 | Olayinka Olaniyi Akinwumiju | Psychiatry & Neurology | 8130 Country Village Dr Ste 102, Cordova, TN 38016 | 2006-07-15 |
| 1942254602 | Martha A. Gordon | Psychiatry & Neurology | 150 Timber Creek Dr Ste 6, Cordova, TN 38018-4236 | 2006-05-19 |
| Find all providers in CORDOVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.