Alice Yue-XI Chan

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

2018-01158 Issued in NC

Practice address

1806 S Hawthorne Rd Ste 100
Winston Salem, NC 27103-4014

Phone

(336) 718-2560

Fax

(336) 718-2569

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Pediatric Cardiology Physician
  • Winston Salem, NC
  • NPI 1619599198
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1497140628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-2560",
            "fax_number": "336-718-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 S HAWTHORNE RD STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034014",
            "telephone_number": "336-718-2560",
            "fax_number": "336-718-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Heart Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278348982",
            "country_code": "US",
            "telephone_number": "252-744-5601",
            "fax_number": "252-744-3814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ALICE",
        "middle_name": "YUE-XI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NC",
            "license": "2018-01158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy D Chambers
• Anna Chamness
• Allen H. Chamovitz, M.D.
• Champion Family Healthcare Services, LLC
• Champion Family Healthcare Services, LLC
• Channey Chan
• Michael David Chan, M.D.
• Wendy Chan, MAC
• Nicole Christine Chanas, PHARMD
• Chances Make Champions LLC

• Pediatric Cardiology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatric Cardiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.