Active NPI
Cheng Tsing Pan, MD
- Psychiatry Physician
- Tipp City, OH
National Provider Identifier
1659366086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35056072
- Practice address
- 227 S Garber Dr
Tipp City, OH 45371-1183 - Phone
- (937) 667-6774
- Fax
- (937) 667-2826
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35056072 | OH | Primary |
Addresses
Primary practice location
227 S Garber Dr
Tipp City, OH 45371-1183
Mailing address
227 S Garber Dr
Tipp City, OH 45371-1183
Phone (937) 667-6774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0817629 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35056072 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1659366086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 S GARBER DR",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453711183",
"telephone_number": "937-667-6774",
"fax_number": "937-667-2826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 S GARBER DR",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453711183",
"telephone_number": "937-667-6774",
"fax_number": "937-667-2826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "CHENG",
"middle_name": "TSING",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "35056072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0817629",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tipp City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.