Individual provider Active NPI

Shi Xun Fang

  • Psychiatry Physician
  • Cary, NC
National Provider Identifier
1609455195
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2025-01831 Issued in NC
Practice address
15000 Weston Pkwy Ofc 171
Cary, NC 27513-2118
Phone
(833) 351-8255
NPI assigned
Apr 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 339253 NY
Psychiatry Physician 2084P0800X 2025-01831 NC Primary

Addresses

Primary practice location

15000 Weston Pkwy Ofc 171
Cary, NC 27513-2118

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

109 W 27th St Rm 5S
New York, NY 10001-6208
Phone (833) 351-8255

Other names 1

  • Dave Fang Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251220000308 NC Practitioner - Psychiatry 9537563846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

15000 Weston Pkwy
Private Office 171
Cary, NC 27513-2118
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-01831NCMDPsychiatry Physician
339253NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Oct 4, 2025 Accepting new patients

Locations

15000 Weston Pkwy
Ofc 171
Cary, NC 27513
Phone (919) 925-3927

555 Fayetteville St
Ste 201
Raleigh, NC 27601
Phone (919) 780-4178

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 1

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1609455195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 WESTON PKWY OFC 171",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132118",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Rm 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016208",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANG",
        "first_name": "SHI XUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "339253",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2025-01831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVE",
            "last_name": "FANG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.