Individual provider Active NPI

Yu Wei Shan, PMHNP-BC

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1700339785
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008664 Issued in NC
Practice address
1900 Randolph Rd
Suite 800
Charlotte, NC 28207-1122
Phone
(704) 384-1246
Fax
(704) 384-6072
NPI assigned
Jul 26, 2016
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 234451 NC
Nurse Practitioner 363L00000X 5008664 NC Primary

Addresses

Primary practice location

1900 Randolph Rd
Suite 800
Charlotte, NC 28207-1122

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1246

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yshan403312@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161202001624 NC Practitioner - Nurse Practitioner 2668752999 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

3545 Whitehall Park Dr
Suite 300
Charlotte, NC 28273-4179
Phone (980) 302-8850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008664NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Jul 13, 2018 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 10, 2016 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 26, 2022 Accepting new patients
NMG Health Services LLC CurrentSince Feb 15, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 10, 2016 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Adamu Salisu, MD PLLC CurrentSince Mar 29, 2017 Accepting new patients
Monarch Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Feb 15, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 26, 2022 Accepting new patients
Monarch CurrentSince Jul 13, 2018 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

1900 Randolph Rd
Ste 216
Charlotte, NC 28207
Phone (704) 316-5330

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

3057 Freedom Dr
Charlotte, NC 28208
Phone (704) 334-2226

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

1303 E Franklin St
Monroe, NC 28112
Phone (704) 283-4401

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: yshan403312@direct.novanthealth.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1700339785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1246",
            "fax_number": "704-384-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "SUITE 800",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071122",
            "telephone_number": "704-384-1246",
            "fax_number": "704-384-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAN",
        "first_name": "YU WEI",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "234451",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yshan403312@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1900 Randolph Rd",
            "address_2": "Suite 800",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.