Active NPI
Wing C Chan, MD
- Anatomic Pathology & Clinical Pathology Physician
- Omaha, NE
National Provider Identifier
1174577886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 18377
- Practice address
- 988102 Nebraska Medical Ctr
Omaha, NE 68198-8102 - Phone
- (402) 559-4186
- Fax
- (402) 559-6018
- NPI assigned
- May 19, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician | 207RH0000X | 18377 | NE | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 18377 | NE | Primary |
Addresses
Primary practice location
988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Mailing address
988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-4186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47078557547 | Medicaid | NE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Physicians | 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.
-
- Pediatrics Physician
- Omaha, NE
- NPI 1750443503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1174577886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "988102 NEBRASKA MEDICAL CTR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681988102",
"telephone_number": "402-559-4186",
"fax_number": "402-559-6018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "988102 NEBRASKA MEDICAL CTR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681988102",
"telephone_number": "402-559-4186",
"fax_number": "402-559-6018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "WING",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "NE",
"license": "18377",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NE",
"license": "18377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47078557547",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.