Dr Kevin Chan PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DR KEVIN CHAN PC

Practice address

12010 S Warner Elliot Loop Ste 1
Phoenix, AZ 85044-2731

Phone

(480) 961-2366

Fax

(480) 961-2367

NPI assigned

Jun 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Yin Shun Chan, DONPI 1528014248

Title

Owner

Phone

(480) 577-8199

Specialties & licenses 1

Addresses

Other names 2

• Pineapple Health Doing business as
• Pineapple Health PV Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Yin Shun Chan, DO

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1528014248
  Medicare reassignment NPD Authorized official
• Jonne Amorette Housh, MSN, NP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1285847210
  Medicare reassignment NPD
• Jennifer Leanne Lopez

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1326496597
  Medicare reassignment NPD
• Kerry L Oliver, FNP-C

  • Primary Care Nurse Practitioner
  • Phoenix, AZ
  • NPI 1306341748
  Medicare reassignment NPD
• Karie Lynn Fedorick, PA-C

  • Medical Physician Assistant
  • Gilbert, AZ
  • NPI 1689735482
  Medicare reassignment

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1063640977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12010 S WARNER ELLIOT LOOP STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442731",
            "telephone_number": "480-961-2366",
            "fax_number": "480-961-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 S WARNER ELLIOT LOOP STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442731",
            "telephone_number": "480-961-2366",
            "fax_number": "480-961-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3196 N Windsong Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142239",
            "country_code": "US",
            "telephone_number": "928-772-1505",
            "fax_number": "928-772-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR KEVIN CHAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "YIN SHUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-577-8199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pineapple Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pineapple Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pineapple Health PV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dr Greg Muchnij Inc
• Dr Jose a N Gozar MD SC
• Dr Jozef Zoldos PLLC
• Dr Justin Ross PLC
• Dr Kathleen J Richards, PC
• Dr Kimble Foot Specialist, P.L.L.C.
• Dr Lloyd P Champagne PLLC
• Dr Medical Group, LLC
• Dr Nathan Campbell
• Dr Paul L Brandt Jr DDS PC

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.