Individual provider Active NPI

Kam W Chan, MD

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1891759510
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21455 Issued in SC
Practice address
1401 Sam Rittenberg Blvd Ste 6
Charleston, SC 29407-5031
Phone
(843) 973-5393
Fax
(833) 994-1098
NPI assigned
Apr 12, 2006
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21455 SC Primary

Addresses

Primary practice location

1401 Sam Rittenberg Blvd Ste 6
Charleston, SC 29407-5031

Mailing address

1401 Sam Rittenberg Blvd Ste 6
Charleston, SC 29407-5031
Phone (843) 973-5393

Other identifiers 1

IdentifierTypeStateIssuer
L32196MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kam.chan.2@29601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110106000371 SC Practitioner - Family Practice 9234328238 Reassigns benefits to 1 organization
I20220121001975 NC Practitioner - Family Practice 9234328238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1401 Sam Rittenberg Blvd
Suite 6
Charleston, SC 29407-5031
Phone (843) 973-5393

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21455SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (NC) PC Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Centerwell Senior Primary Care NC JV PC Family Medicine Current Accepting new patients
Centerwell Senior Primary Care (SC) PC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Centerwell Senior Primary Care NC JV PC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Centerwell Senior Primary Care (NC) JV, P.C. Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Centerwell Senior Primary Care (SC) PC Family Medicine Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

3512 Wilkinson Blvd
Ste 130
Charlotte, NC 28208
Phone (980) 999-2964

8727 Jw Clay Blvd
Charlotte, NC 28262
Phone (980) 999-1831

2910 E Franklin Blvd
Ste 1
Gastonia, NC 28056
Phone (704) 648-0460

108 Highway 28 Byp
Anderson, SC 29624
Phone (864) 296-5208

1401 Sam Rittenberg Blvd
Ste 6
Charleston, SC 29407
Phone (843) 973-5393

3516 Highway 153
Greenville, SC 29611
Phone (864) 729-6626

Interoperability endpoints

  • Direct secure messaging: kam.chan.1@29601.direct.athenahealth.com
  • Direct secure messaging: kam.chan.2@29601.direct.athenahealth.com
  • Direct secure messaging: kam.chan@420883186974724.direct.elationemr.com
  • Direct secure messaging: kam.chan@centerwell.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1891759510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SAM RITTENBERG BLVD STE 6",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075031",
            "telephone_number": "843-973-5393",
            "fax_number": "833-994-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SAM RITTENBERG BLVD STE 6",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075031",
            "telephone_number": "843-973-5393",
            "fax_number": "833-994-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KAM",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L32196",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kam.chan.2@29601.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "kam.chan.2@29601.direct.athenahealth.com",
            "address_1": "1401 Sam Rittenberg Blvd Ste 6",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294075031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.