NPIMap

Individual provider Active NPI

Nicolas Phan, M.D.

  • Neurological Surgery Physician
  • Huntington, WV
National Provider Identifier
1437328192
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
27731 Issued in WV
Practice address
1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655
Phone
(304) 691-1499
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A102866 CA
Neurological Surgery Physician 207T00000X 27731 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655

Mailing address

1600 Medical Center Dr Ste B500
Huntington, WV 25701-3655
Phone (304) 691-1499

Other names 1

  • Nicolas Phan Cong Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicolas.phan@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, KY, OH3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20171006002585 WV Practitioner - Neurosurgery 5890854566 Reassigns benefits to 1 organization
I20230908001438 KY Practitioner - Neurosurgery 5890854566 Reassigns benefits to 2 organizations
I20250404002745 OH Practitioner - Neurosurgery 5890854566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
McGill University, Faculty of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5050

1600 Medical Ctr Dr
Suite B500
Huntington, WV 25701-3655
Phone (304) 691-1787

7700 Ohio River Rd
Wheelersburg, OH 45694-1653
Phone (740) 574-4616

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion172
Laminectomy or laminotomy (partial removal of spine bones)42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27731WVMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
I Path LLC Current Accepting new patients
University Physicians & Surgeons, Inc. CurrentSince Jul 17, 2017 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
University Physicians & Surgeons, Inc CurrentSince Jul 17, 2017 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jun 10, 2023 Accepting new patients
Holzer Clinic, LLC CurrentSince Mar 3, 2025 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jun 10, 2023 Accepting new patients
Cabell Huntington Hospital Inc Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

617 23rd St
Ste 400
Ashland, KY 41101
Phone (606) 329-1770

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

1600 Medical Center Dr
Ste B500
Huntington, WV 25701
Phone (304) 691-1787

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1249 15th St
Ste 4093
Huntington, WV 25701
Phone (304) 691-8714

414 Greenway Ave
South Charleston, WV 25309
Phone (304) 691-1787

Interoperability endpoints

  • Direct secure messaging: nicolas.phan.1@17389.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437328192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE B500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE B500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "NICOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A102866",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WV",
            "license": "27731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolas.phan@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr Ste B500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLAS",
            "last_name": "PHAN CONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.