John P Imm, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35064477 Issued in OH

Practice address

5700 Monroe St Unit 111
Sylvania, OH 43560-2779

Phone

(567) 585-0005

Fax

(567) 585-0007

NPI assigned

Aug 12, 2005

Last updated

Nov 3, 2023By 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 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Community and Rural Health Services

  dba Birchard Medical Center

  • Rural Health Clinic/Center
  • Fremont, OH
  • NPI 1437321239
  NPD (past)
• Emergency Physicians of Northwest Ohio Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1043274418
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Northwest Ohio Urgent Care Inc

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1710183520
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)
• Promedica Central Physicians

  dba ProMedica Urgent Care

  • Urgent Care Clinic/Center
  • Toledo, OH
  • NPI 1043673700
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1215939848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202967",
            "telephone_number": "419-334-8943",
            "fax_number": "419-334-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 111",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602779",
            "telephone_number": "567-585-0005",
            "fax_number": "567-585-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Golden Gate Plz",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435372881",
            "country_code": "US",
            "telephone_number": "567-585-0210",
            "fax_number": "419-794-4604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6711 Airport Hwy",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "OH",
            "postal_code": "435288104",
            "country_code": "US",
            "telephone_number": "567-585-0070",
            "fax_number": "567-703-8685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3430 Secor Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436061547",
            "country_code": "US",
            "telephone_number": "567-585-0225",
            "fax_number": "419-214-3564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3316 Navarre Ave # F",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436163314",
            "country_code": "US",
            "telephone_number": "419-291-1420",
            "fax_number": "419-214-3841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6755 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171109",
            "country_code": "US",
            "telephone_number": "567-585-0075",
            "fax_number": "419-517-7105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMM",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35064477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4553666",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "15-70029",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0992010",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "04213",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZNTHEM",
            "identifier": "000000277395",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "080191952",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jimm25566@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amanda Ibanez
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• Madison Imboden
• Gary J Incorvaia, LISW-S
• Industrial Health Consultants
• Infusion Partners LLC (BioScrip Infusion Services)
• Infusion Partners, LLC (BioScrip Infusion Services)
• Joe F Inman, D.D.S.

• Family Medicine Physician in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.