Daniel Kan, MD

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

ME41683 Issued in FL

Practice address

4056 E Sr 44
Wildwood, FL 34785-7486

Phone

(352) 268-0003

Fax

(855) 642-1129

NPI assigned

Jun 30, 2006

Last updated

Aug 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Neurology Group PA

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  • NPI 1255563961
  NPD (past)
• Neuromed,Inc

  • Electroneurodiagnostic Specialist/Technologist
  • Manchester, TN
  • NPI 1639395213
  NPD (past)
• Neurometric Centers of Tennessee Inc

  • Specialist
  • Manchester, TN
  • NPI 1457551368
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1609805977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 HIGHWAY 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321596340",
            "telephone_number": "352-268-0003",
            "fax_number": "855-642-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4056 E SR 44",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857486",
            "telephone_number": "352-268-0003",
            "fax_number": "855-642-1129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17190 SE 109th Terrace Rd",
            "address_purpose": "LOCATION",
            "city": "Summerfield",
            "state": "FL",
            "postal_code": "344919017",
            "country_code": "US",
            "telephone_number": "352-268-0003",
            "fax_number": "855-642-1129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAN",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-08-12",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TN",
            "license": "MD0000038597",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "FL",
            "license": "ME41683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N0608",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042166900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisha Kerr Jacobsen
• Jasmine Jones, RN, MSN
• Karen W. Jones, ARNP
• Tonya Marie Jones, M.A.
• Karen L. Judd, PHD,CISW
• Erika Song Kang
• Soumya Kavuluri
• Jordan Brent Kennedy, DMD
• Kids Central, Inc.
• Judith Eun Kim

• Addiction Psychiatry Physician in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Addiction Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.