Ken-Shih Fan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2025-02593 Issued in NC

Practice address

1125 Carthage St
Sanford, NC 27330-4162

Phone

(919) 774-6023

NPI assigned

May 4, 2022

Last updated

Jul 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Central Carolina Medical Group LLCGroup PAC ID 3577840420, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Central Carolina Hospital Hospital, Sanford, NC, CCN 340020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ken-shih.fan.1@15593.direct.athenahealth.com

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.

• DLP Central Carolina Medical Group LLC

  dba Central Caroling Urology

  • Urology Physician
  • Sanford, NC
  • NPI 1184163883
  Medicare reassignment Care Compare group NPD
• DLP Central Carolina Medical Group LLC

  dba Central Carolina Sandhills Family Care

  • Rural Health Clinic/Center
  • Sanford, NC
  • NPI 1174208813
  NPD
• DLP Central Carolina Medical Group LLC

  dba Central Carolina Sandhills Family Care

  • Rural Health Clinic/Center
  • Broadway, NC
  • NPI 1578254215
  NPD

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

• DLP Central Carolina Medical Center LLC

  dba Central Carolina Hospital

  • General Acute Care Hospital
  • Sanford, NC
  • NPI 1902836943
  Care Compare affiliation

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1386389146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 HAVEN CREEK RD APT 210",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273121858",
            "telephone_number": "919-327-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304162",
            "telephone_number": "919-774-6023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352591",
            "country_code": "US",
            "telephone_number": "814-333-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "KEN-SHIH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2025-07-25",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-02593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Preservation Services of NC, Inc - Sanford DT
• Family Preservation Services of NC, Inc - Sanford Iih
• Family Preservation Services of NC, Inc - Sanford Opt
• Family Preservation Services of NC, Inc Sanford-Sacot
• Family Preservation Services of North Carolina, Inc-Sanford-Saiop
• Christina Farmer
• Fast Pace Kentucky PLLC (Fast Pace Health)
• Randolph Kelly Faulk Jr., DDS
• Kaprice Reevea Faust
• Fayetteville Vamc

• Family Medicine Physician in Sanford, NC
• Providers in Sanford, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.