Individual provider Active NPI

Kinh Luan Dinh Phan, MD

  • Psychiatry Physician
  • Columbus, OH
National Provider Identifier
1548389109
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.136300 Issued in OH
Practice address
1670 Upham Dr FL 3
Columbus, OH 43210-1250
Phone
(614) 293-9600
Fax
(614) 366-1215
NPI assigned
Mar 28, 2007
Last updated
May 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.136300 OH Primary

Addresses

Primary practice location

1670 Upham Dr FL 3
Columbus, OH 43210-1250

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-9600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190813001671 OH Practitioner - Psychiatry 6608833231 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.136300OHMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: lphan753946@direct.osumc.edu

Organizations & group practices 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1548389109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-9600",
            "fax_number": "614-366-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR FL 3",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-9600",
            "fax_number": "614-366-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KINH LUAN",
        "middle_name": "DINH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.136300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.