Active NPI
Eric C Fan, D.O.
- Psychiatry Physician
- Albany, GA
National Provider Identifier
1629191663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 49615
- Practice address
- 601 11TH Ave
Albany, GA 31701-1645 - Phone
- (850) 766-6566
- Fax
- (229) 233-0927
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 49615 | GA | Primary |
Addresses
Primary practice location
601 11TH Ave
Albany, GA 31701-1645
Mailing address
103 Laurel Oak LN
Thomasville, GA 31792-7647
Phone (850) 766-6566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Area Community SVC. Board | Current | Accepting new patients | |
| Middle Flint Area Community Service Board | Current | Accepting new patients | |
| Middle Flint Area Community Service Board | Current | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
601 11th Ave
Albany, GA 31701
Phone (229) 352-9368
415 N Jackson St
Americus, GA 31709
Phone (229) 815-5454
Organizations & group practices 4
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.
-
- Public Health or Welfare Agency
- Albany, GA
- NPI 1063464212
-
- Community/Behavioral Health Agency
- Fort Valley, GA
- NPI 1366521932
-
- Community/Behavioral Health Agency
- Americus, GA
- NPI 1487822599
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1629191663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 LAUREL OAK LN",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317927647",
"telephone_number": "850-766-6566",
"fax_number": "229-233-0927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 11TH AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317011645",
"telephone_number": "850-766-6566",
"fax_number": "229-233-0927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAN",
"first_name": "ERIC",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "49615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.