Active NPI
Mel G Marilim, M.D.
- Family Medicine Physician
- Clinton, IA
National Provider Identifier
1225080666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 33241
- Practice address
- 915 13TH Ave N
Clinton, IA 52732-5067 - Phone
- (563) 243-2511
- Fax
- (563) 243-0817
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 33241 | IA | Primary |
| Family Medicine Physician | 207Q00000X | 036-088251 | IL |
Addresses
Primary practice location
915 13TH Ave N
Clinton, IA 52732-5067
Mailing address
915 13TH Ave N
Clinton, IA 52732-5067
Phone (563) 243-2511
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11431 | Other | IA | WELLMARK BC/BS |
| 049102 | Other | HEALTH ALLIANCE | |
| 0201806 | Medicaid | IA | |
| 09822166 | Other | IL | BLUE CROSS / BLUE SHIELD |
| IA0178 | Other | JOHN DEERE HEALTH | |
| 147067 | Other | IOWA HEALTH SOLUTIONS | |
| 19345 | Other | MIDLANDS CHOICE | |
| 036088251 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33241 | IA | MD | Family Medicine Physician |
| 036-088251 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363305600000",
"number": "1225080666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 13TH AVE N",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325067",
"telephone_number": "563-243-2511",
"fax_number": "563-243-0817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 13TH AVE N",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325067",
"telephone_number": "563-243-2511",
"fax_number": "563-243-0817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARILIM",
"first_name": "MEL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2013-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "33241",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-088251",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "11431",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "049102",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0201806",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS / BLUE SHIELD",
"identifier": "09822166",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH",
"identifier": "IA0178",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA HEALTH SOLUTIONS",
"identifier": "147067",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "19345",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036088251",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.