Individual provider Active NPI

Nim Chan, MD

  • Pulmonary Disease Physician
  • Greenville, NC
National Provider Identifier
1295228948
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2024-01142 Issued in NC
Practice address
521 Moye Blvd
Greenville, NC 27834-2849
Phone
(252) 744-1600
Fax
(252) 744-1115
NPI assigned
Jun 7, 2018
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2024-01142 NC Primary

Addresses

Primary practice location

521 Moye Blvd
Greenville, NC 27834-2849

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nchan352872@direct.ecuhealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240712000591 NC Practitioner - Pulmonary Disease 4385044981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

521 A Moye Blvd
Greenville, NC 27834-2849
Phone (252) 744-1111

606 E 12TH St
Washington, NC 27889-3409
Phone (252) 974-9460

608 E 12TH St
Vidant Multispecialty Clinic Washiington
Washington, NC 27889-3409
Phone (252) 974-7500

628 E 12TH St
Vidant Beaufort Hospitalists
Washington, NC 27889-3409
Phone (252) 975-4178

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-01142NCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Jun 15, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince May 1, 2025 Accepting new patients
Outer Banks Professional Services, LLC CurrentSince Jul 10, 2025 Accepting new patients
East Carolina University Current Accepting new patients
East Carolina University PastSince Jun 15, 2024 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

521 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1600

521 Moye Blvd
#A
Greenville, NC 27834
Phone (252) 744-1111

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

Organizations & group practices 5

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 3

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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1295228948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342849",
            "telephone_number": "252-744-1600",
            "fax_number": "252-744-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "NIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2024-01142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nchan352872@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "521 Moye Blvd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.