NPIMap

Individual provider Active NPI

Marvin Im, D.O.

  • Family Medicine Physician
  • Dublin, OH
National Provider Identifier
1154436665
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34007591 Issued in OH
Practice address
6425 Post Rd Ste 102
Dublin, OH 43016-1347
Phone
(614) 813-0883
Fax
(614) 813-7173
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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 34007591 OH Primary

Addresses

Primary practice location

6425 Post Rd Ste 102
Dublin, OH 43016-1347

Mailing address

6425 Post Rd Ste 102
Dublin, OH 43016-1347
Phone (614) 813-0883

Other identifiers 1

IdentifierTypeStateIssuer
2285781MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20061018000361 OH Practitioner - Family Practice 0042216889 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6425 Port Rd
Suite 102
Dublin, OH 43016
Phone (614) 813-0883

6425 Post Rd
Suite 102
Dublin, OH 43016-1347

Hospital & facility affiliations

  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Memorial Hospital Hospital, Marysville, OH, CCN 360092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007591OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jul 1, 2009 Accepting new patients
Synergy Medical, LLC CurrentSince Dec 4, 2017 Accepting new patients
Capital City Regenerative Medicine LLC Family Medicine CurrentSince Apr 3, 2024 Accepting new patients
Ohiohealth Corporation Family Medicine Current Accepting new patients
Elevate Medical Group Family Medicine CurrentSince Jan 9, 2026 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2009 Accepting new patients
Buckeye Sports and Family Chiropractice Center, Inc PastSince Dec 4, 2017 Accepting new patients
Zile Family Health Care, Inc. Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6200 Cleveland Ave
Columbus, OH 43231
Phone (614) 566-0590

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

6425 Post Rd
Ste 101
Dublin, OH 43016
Phone (614) 760-5555

5610 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 476-1112

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

16705 Square Dr
Marysville, OH 43040
Phone (937) 400-2011

1797 Hill Rd N
Pickerington, OH 43147
Phone (614) 755-6370

5577 N High St
Ste B
Worthington, OH 43085
Phone (614) 400-4301

5577 N High St
Ste A
Worthington, OH 43085
Phone (614) 436-3870

Interoperability endpoints

  • Direct secure messaging: marvin.im.1@18852.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1154436665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 POST RD STE 102",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161347",
            "telephone_number": "614-813-0883",
            "fax_number": "614-813-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 POST RD STE 102",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161347",
            "telephone_number": "614-813-0883",
            "fax_number": "614-813-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2285781",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.