Individual provider Active NPI

Gary CHI-Hung Chan, DO

  • Cardiovascular Disease Physician
  • Canton, GA
National Provider Identifier
1548649254
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
99861 Issued in GA
Practice address
15 Reinhardt College Pkwy Ste 110a
Canton, GA 30114-5257
Phone
(770) 720-2383
Fax
(833) 605-3236
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 99861 GA
Cardiovascular Disease Physician 207RC0000X DO-05713 IA
Cardiovascular Disease Physician 207RC0000X 99861 GA Primary

Addresses

Primary practice location

15 Reinhardt College Pkwy Ste 110a
Canton, GA 30114-5257

Mailing address

15 Reinhardt College Pkwy Ste 110a
Canton, GA 30114-5257

Other practice location 1

801 5th St Ste 5851
Sioux City, IA 51101-1326
Phone (712) 294-7022

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gary.chan.p20@direct.trinity-healthiowa.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210715001689 IA Practitioner - Cardiovascular Disease (Cardiology) 8921400748
I20240806004005 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8921400748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

15 Reinhardt College Pkwy
Suite 110
Canton, GA 30114-5259
Phone (770) 720-2383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05713IAMDClinical Social Worker
DO-05713IAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Jun 23, 2024 Accepting new patients
Mercy Medical Services PastSince Jul 1, 2021 Accepting new patients
Baptist Health System, Inc. Internal Medicine Past Accepting new patients
Baptist Health System, Inc. Internal Medicine Past Accepting new patients
Piedmont Professional Services, LLC Cardiovascular Disease Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

15 Reinhardt College Pkwy
Ste 110
Canton, GA 30114
Phone (770) 720-2383

15 Reinhardt College Pkwy
Ste 110A
Canton, GA 30114
Phone (770) 720-2383

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1548649254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY STE 110A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY STE 110A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257",
            "telephone_number": "770-720-2383",
            "fax_number": "833-605-3236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 5th St Ste 5851",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511011326",
            "country_code": "US",
            "telephone_number": "712-294-7022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "GARY",
        "middle_name": "CHI-HUNG",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "99861",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "DO-05713",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "99861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gary.chan.p20@direct.trinity-healthiowa.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "MercyOne West Iowa Direct Email Address",
            "address_1": "801 5th St Ste 5851",
            "city": "Sioux City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "511011326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.