Individual provider Active NPI

Fang Wan, L.AC

  • Acupuncturist
  • Atlanta, GA
National Provider Identifier
1497306716
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1776 Issued in MN
Practice address
6255 Barfield Rd Ste 175
Atlanta, GA 30328-4338
Phone
(719) 828-1166
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1776 MN Primary

Addresses

Primary practice location

6255 Barfield Rd Ste 175
Atlanta, GA 30328-4338

Mailing address

6255 Barfield Rd Ste 175
Atlanta, GA 30328-4338
Phone (719) 828-1166

Other practice location 1

3425 Clubland Dr
Marietta, GA 30068-2506
Phone (719) 828-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1776MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Chinese Medicine LLC Acupuncturist CurrentSince Nov 1, 2023 Accepting new patients
Metro Acupuncture Center, Inc. Acupuncturist Current Accepting new patients

Locations

5555 Erindale Dr
Ste 107
Colorado Springs, CO 80918
Phone (719) 354-5378

6255 Barfield Rd
Ste 175
Sandy Springs, GA 30328
Phone (404) 255-1846

7373 147th St W
Ste 176
Apple Valley, MN 55124

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1497306716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 BARFIELD RD STE 175",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284338",
            "telephone_number": "719-828-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 BARFIELD RD STE 175",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284338",
            "telephone_number": "719-828-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3425 Clubland Dr",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300682506",
            "country_code": "US",
            "telephone_number": "719-828-1166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAN",
        "first_name": "FANG",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.