NPIMap

Organization Active NPI

Radnor Family Practice Professional Limited Liability Company

Doing business as IM Health

  • Family Medicine Physician
  • Wayne, PA
National Provider Identifier
1750407144
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RADNOR FAMILY PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANY
Doing business as
IM Health
Practice address
372 W Lancaster Ave
Wayne, PA 19087-3924
Phone
(610) 688-8807
NPI assigned
Mar 21, 2007
Last updated
Feb 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
RADNOR FAMILY PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Dr. Rocklan David Walker, D.O.NPI 1629009881
Title
Ceo
Phone
(610) 688-8807

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Registered Dietitian 133V00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

372 W Lancaster Ave
Wayne, PA 19087-3924

Mailing address

372 W Lancaster Ave
Wayne, PA 19087-3924
Phone (610) 688-8807

Other names 1

  • IM Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050216000158 PA Part B Supplier - Clinic/Group Practice 4183676364 Receives reassigned benefits from 28 practitioners
3 other NPIs on this enrollment
Practice locations: Wayne, PA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Radnor Family Practice PLLC Dba Im Health

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1750407144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 W LANCASTER AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873924",
            "telephone_number": "610-688-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 W LANCASTER AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873924",
            "telephone_number": "610-688-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADNOR FAMILY PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADNOR FAMILY PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANY",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ROCKLAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-688-8807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IM Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.