Fan XI, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

200501873 Issued in NC

Practice address

2800 Ashton Drive
Suite 100
Wilmington, NC 28412-2486

Phone

(910) 794-8892

Fax

(910) 794-8895

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Merit-based Incentive Payment System (MIPS)

Final score

55 of 100Reported as individual

Quality

30

Improvement activities

40

Cost

10

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Independence Rehabilitation LLC

  • Physical Medicine & Rehabilitation Physician
  • Vineland, NJ
  • NPI 1144624560
  Medicare reassignment NPD Authorized official
• Coastal Rehabilitation Associates

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wilmington, NC
  • NPI 1851348981
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1881619005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ASHTON DRIVE",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122486",
            "telephone_number": "910-794-8892",
            "fax_number": "910-794-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ASHTON DRIVE",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122486",
            "telephone_number": "910-794-8892",
            "fax_number": "910-794-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XI",
        "first_name": "FAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NC",
            "license": "200501873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902676",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Wulf
• Walter J Wulf, DDS PA
• Erick Tyler Wynkoop, PA
• Taylor Christine Wynn
• Wynne Chiropractic Ctr PA
• Allen Xu, DO
• Jill Ferrell Yapple, LPA, HSP
• Charles Curtis Yarborough
• David Glenn Yarborough III, PHD
• Marianne Yarnall

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.