Individual provider Active NPI

Hakeem Malin, DNP, PRACTITIONER

  • Gerontology Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1508397860
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.020612 Issued in OH
Practice address
1000 Georgesville Rd
Columbus, OH 43228-3304
Phone
(614) 274-7771
Fax
(614) 274-7720
NPI assigned
Mar 27, 2017
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.020612 OH Primary

Addresses

Primary practice location

1000 Georgesville Rd
Columbus, OH 43228-3304

Mailing address

1000 Georgesville Rd
Columbus, OH 43228-3304
Phone (614) 274-7771

Other practice location 1

100 N Murray Hill Rd
Columbus, OH 43228-1590
Phone (614) 878-6400

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170504001151 OH Practitioner - Nurse Practitioner 6901062959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.020612OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Home Care Village, LLC Current Accepting new patients
Mohammed I Ahmed MD Inc CurrentSince Apr 3, 2019 Accepting new patients
Westland Family Care LLC PastSince Nov 13, 2022 Accepting new patients
Midland Medical Group, LLC PastSince Apr 10, 2022 Accepting new patients

Locations

6850 Perimeter Dr
Ste D
Dublin, OH 43016
Phone (614) 352-5679

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1508397860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GEORGESVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432283304",
            "telephone_number": "614-274-7771",
            "fax_number": "614-274-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GEORGESVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432283304",
            "telephone_number": "614-274-7771",
            "fax_number": "614-274-7720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Murray Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281590",
            "country_code": "US",
            "telephone_number": "614-878-6400",
            "fax_number": "614-918-3421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIN",
        "first_name": "HAKEEM",
        "name_prefix": "Dr.",
        "credential": "DNP, PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.020612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.