Jimmy Nicolas Pan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2023-02430 Issued in NC

Practice address

34 Healthpark Way Ste 100
Clayton, NC 27520-4497

Phone

(919) 585-8850

Fax

(919) 585-8869

NPI assigned

Mar 23, 2020

Last updated

Jan 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114
• Johnston Health Hospital, Smithfield, NC, CCN 340090

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpan1069082@direct.unc.nchie.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unc Physicians Network LLC

  dba UNC Family Medicine at Pittsboro

  • Family Medicine Physician
  • Pittsboro, NC
  • NPI 1750704367
  Medicare reassignment Care Compare group NPD
• Unc Physicians Network LLC

  • General Practice Physician
  • Morrisville, NC
  • NPI 1558786830

  Family Medicine

  NPD
• Unc Physicians Network, LLC

  dba Carolina Advanced Health

  • Internal Medicine Physician
  • Chapel Hill, NC
  • NPI 1295016038
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnston Health Services Corporation

  dba Johnston Health

  • General Acute Care Hospital
  • Smithfield, NC
  • NPI 1619911104
  Care Compare affiliation
• Rex Hospital Inc.

  dba Rex Hospital

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1770110512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HEALTHPARK WAY STE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204497",
            "telephone_number": "919-585-8850",
            "fax_number": "919-585-8869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043425",
            "country_code": "US",
            "telephone_number": "910-678-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAN",
        "first_name": "JIMMY",
        "middle_name": "NICOLAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-02430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpan1069082@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "34 Healthpark Way Ste 100",
            "city": "Clayton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275204497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gretchen N Paavola
• Caitlyn Jenkins Pabon, MS, NCC, LCMHC
• Mary Katrina Padgett, PA-C
• Emily Painter
• Melissa J Palmer, M.A., CCC-A
• Pandora Family Care Home LLC
• Pandora Famiyl Care Home LLC
• Antara Pradip Parkar, PT
• Grace Parker, DPT
• Kimberly Anne Parker

• Family Medicine Physician in Clayton, NC
• Providers in Clayton, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.