NPIMap

Individual provider Active NPI

William Li-Goon Fan, M.D.

  • Nephrology Physician
  • Raleigh, NC
National Provider Identifier
1902884000
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
200200682 Issued in NC
Practice address
3700 Barrett Dr Ste 200
Raleigh, NC 27609-7172
Phone
(919) 231-3966
Fax
(919) 231-3912
NPI assigned
Jan 9, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 200200682 NC Primary

Addresses

Primary practice location

3700 Barrett Dr Ste 200
Raleigh, NC 27609-7172

Mailing address

3700 Barrett Dr Ste 200
Raleigh, NC 27609-7172
Phone (919) 231-3966

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ncnephrologyassociates@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324001269 NC Practitioner - NephrologyPractitioner - Internal Medicine 9335195007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina Nephrology PAGroup PAC ID 0244511483, 58 clinicians

Practice addresses (Care Compare)

1559 E Booker Dairy Rd
Suite B
Smithfield, NC 27577-9442
Phone (919) 876-7807

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Nephrology PA Nephrology Current Accepting new patients
North Carolina Nephrology PA Nephrology CurrentSince Jan 1, 2017 Accepting new patients
North Carolina Nephrology PA Nephrology CurrentSince Jan 1, 2017 Accepting new patients

Locations

160 Macgregor Pines Dr
Ste 301
Cary, NC 27511
Phone (800) 957-9242

3031 New Bern Ave
Ste 306
Raleigh, NC 27610
Phone (919) 459-8409

3604 Bush St
Raleigh, NC 27609

3700 Barrett Dr
Ste 200
Raleigh, NC 27609
Phone 91923139662244

1559 E Booker Dairy Rd
Ste B
Smithfield, NC 27577

2824 Rogers Rd
Ste 104
Wake Forest, NC 27587

Interoperability endpoints

  • Direct secure messaging: wfan193274@direct.medicine.duke.edu
  • Direct secure messaging: wfan24308@direct.acumenmd.com

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1902884000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BARRETT DR STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097172",
            "telephone_number": "919-231-3966",
            "fax_number": "919-231-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 BARRETT DR STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097172",
            "telephone_number": "919-231-3966",
            "fax_number": "919-231-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "WILLIAM",
        "middle_name": "LI-GOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "200200682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncnephrologyassociates@directaddress.net",
            "affiliation": "N",
            "address_1": "3700 Barrett Dr Ste 200",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276097172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.