Individual provider Active NPI

John G Fan, MD

  • Physical Medicine & Rehabilitation Physician
  • Hutchinson, KS
National Provider Identifier
1225099203
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
04-31786 Issued in KS
Practice address
2101 N Waldron St
Hutchinson, KS 67502-1131
Phone
(620) 669-2500
Fax
(620) 669-2205
NPI assigned
Mar 30, 2006
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 04-31786 KS Primary

Addresses

Primary practice location

2101 N Waldron St
Hutchinson, KS 67502-1131

Mailing address

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

Other identifiers 1

IdentifierTypeStateIssuer
200375390AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnfan@hcpa.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20060601000184 KS Practitioner - Physical Medicine and Rehabilitation 0648281808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians

Practice addresses (Care Compare)

1100 N Main St
Hutchinson, KS 67501-4406
Phone (620) 669-6690

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, P.a., Inc. CurrentSince Jul 1, 2006 Accepting new patients
Heartland Radiation Oncology Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, PA, Inc. CurrentSince Jul 1, 2006 Accepting new patients
Hutchinson Clinic, P.a. Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Ambulatory Surgery Center, LLC Past Accepting new patients

Locations

1100 N Main St
Hutchinson, KS 67501
Phone (620) 669-2500

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

Interoperability endpoints

  • Direct secure messaging: johnfan@hcpa.allscriptsdirect.net

Organizations & group practices 7

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 1

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1225099203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500",
            "fax_number": "620-669-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500",
            "fax_number": "620-669-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "04-31786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200375390A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnfan@hcpa.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "HUTCHINSON CLINIC, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2101 N Waldron St",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

Verify at the official NPI Registry.