NPIMap

Organization Active NPI

Radnor Family Practice, PLLC, Dba Im Health

Doing business as IM Health Physical Medicine

  • Physical Therapist
  • Wayne, PA
National Provider Identifier
1003575788
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RADNOR FAMILY PRACTICE, PLLC, DBA IM HEALTH
Doing business as
IM Health Physical Medicine
Practice address
372 W Lancaster Ave FL 1
Wayne, PA 19087-3924
Phone
(610) 688-8807
Fax
(610) 688-2970
NPI assigned
Dec 10, 2021
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
RADNOR FAMILY PRACTICE, PLLC, DBA IM HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Emily Marie Fisk
Title
Managing Director
Phone
(610) 688-8807

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

372 W Lancaster Ave FL 1
Wayne, PA 19087-3924

Mailing address

372 W Lancaster Ave FL 1
Wayne, PA 19087-3924

Other names 1

  • IM Health Physical Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050216000158 PA Part B Supplier - Clinic/Group Practice 4183676364 Receives reassigned benefits from 28 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wayne, PA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Radnor Family Practice3 organizations share this tax ID, including this one
Part of
Radnor Family Practice

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFADBA

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1003575788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 W LANCASTER AVE FL 1",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 W LANCASTER AVE FL 1",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873924",
            "telephone_number": "610-688-8807",
            "fax_number": "610-688-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADNOR FAMILY PRACTICE, PLLC, DBA IM HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADNOR FAMILY PRACTICE, PLLC, DBA IM HEALTH",
        "enumeration_date": "2021-12-10",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "FISK",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "610-688-8807"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IM Health Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.