Kan Y Wu, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036113712 Issued in IL

Practice address

907 West Lincoln Ave
Charleston, IL 61920-2413

Phone

(217) 345-2500

Fax

(217) 345-8366

NPI assigned

Sep 30, 2005

Last updated

Apr 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Central Illinois Radiology Associates, LLC

  • Diagnostic Radiology Physician
  • Danville, IL
  • NPI 1912277443
  Medicare reassignment NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• North Platte Nebraska Hospital Corporation

  dba Great Plains Health

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332

  Diagnostic Radiology

  NPD (past)
• North Platte Nebraska Physician Group LLC

  dba Great Plains Nephrology

  • Nephrology Physician
  • North Platte, NE
  • NPI 1386187375
  NPD (past)
• Radiology Services, P.C.

  • Diagnostic Radiology Physician
  • North Platte, NE
  • NPI 1851476436
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1972590362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "address_2": "907 WEST LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202413",
            "telephone_number": "217-345-2500",
            "fax_number": "217-345-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 WEST LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202413",
            "telephone_number": "217-345-2500",
            "fax_number": "217-345-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "KAN",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "18855",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036113712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113712",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "01098",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry R. White, PHD
• Shirley Anne White
• Jane Elizabeth Wilson, MA, LCPC
• Lindsay Paige Wilson, LCPC
• Veronica N Wright, APN

• Diagnostic Radiology Physician in Charleston, IL
• Providers in Charleston, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.

Verify at the official NPI Registry.