NPIMap

Individual provider Active NPI

Tai-Hwang Michael Fan, M.D.

  • Cardiovascular Disease Physician
  • Montgomery, AL
National Provider Identifier
1225041627
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20255 Issued in AL
Practice address
440 Taylor Rd
Suite 3230
Montgomery, AL 36117-3588
Phone
(334) 260-9142
NPI assigned
Aug 15, 2006
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 20255 AL Primary

Addresses

Primary practice location

440 Taylor Rd
Suite 3230
Montgomery, AL 36117-3588

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 227-8140

Other practice location 1

1500 W Poplar Ave
Collierville, TN 38017-0601
Phone (901) 227-8140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000005 TN Practitioner - Cardiovascular Disease (Cardiology) 7214067370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
State University of New York at Buffalo School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Electrocardiographic Physicians PLLCGroup PAC ID 0749332385, 2 clinicians

Practice addresses (Care Compare)

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5870

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20255ALMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Vascular Specialists, PC PastSince Jun 1, 2022 Accepting new patients
University of South Alabama Health Services Foundation Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.372198

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1225041627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-227-8140",
            "fax_number": "901-227-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 TAYLOR RD",
            "address_2": "SUITE 3230",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173588",
            "telephone_number": "334-260-9142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380170601",
            "country_code": "US",
            "telephone_number": "901-227-8140",
            "fax_number": "901-227-2477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "TAI-HWANG",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "20255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.