NPIMap

Organization Active NPI

Jim Pang MD PLLC

Doing business as Interventional Psychiatry Group

  • Clinic/Center
  • Cordova, TN
National Provider Identifier
1447620901
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
017659 Issued in TN
Legal business name
JIM PANG MD PLLC
Doing business as
Interventional Psychiatry Group
Jim Pang, Jr., M.D.
Practice address
8000 Centerview Pkwy Ste 301
Cordova, TN 38018-4131
Phone
(901) 752-4900
Fax
(901) 752-4902
NPI assigned
Sep 28, 2015
Last updated
Jul 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Hamilton
Title
Practice Administrator
Phone
(901) 752-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 017659 TN Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

8000 Centerview Pkwy Ste 301
Cordova, TN 38018-4131

Mailing address

8000 Centerview Pkwy Ste 301
Cordova, TN 38018-4131
Phone (901) 752-4900

Other identifiers 1

IdentifierTypeStateIssuer
Q035474MedicaidTN

Other names 2

  • Interventional Psychiatry Group Doing business as
  • Jim Pang, Jr., M.D. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181001001383 TN Part B Supplier - Clinic/Group Practice 4688925696 Receives reassigned benefits from 14 practitioners
Practice locations: Cordova, TN
O20231031000968 MS Part B Supplier - Clinic/Group Practice 4688925696 Receives reassigned benefits from 2 practitioners
Practice locations: Olive Branch, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2117056Jim Pang, MD, PLLC8000 Centerview Parkway, Suite 301, Cordova, TN 38018Certificate of waiverApr 5, 2028

National Provider Directory

National Provider Directory

Locations

65 Germantown Ct
Ste 402
Cordova, TN 38018
Phone (901) 752-4900

8001 Centerview Pkwy
Ste 120
Cordova, TN 38018
Phone 90175249005

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1447620901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 CENTERVIEW PKWY STE 301",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184131",
            "telephone_number": "901-752-4900",
            "fax_number": "901-752-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 CENTERVIEW PKWY STE 301",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184131",
            "telephone_number": "901-752-4900",
            "fax_number": "901-752-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM PANG MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-752-4900"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TN",
            "license": "017659",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035474",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interventional Psychiatry Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jim Pang, Jr., M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.