Marvin Jim

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

11221 N 28TH Dr BLDG E
Phoenix, AZ 85029-5615

Phone

(602) 997-2233

NPI assigned

Dec 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD
• Southwest Behavioral Health Services,Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bullhead City, AZ
  • NPI 1093942161
  NPD

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1841900529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11221 N 28TH DR BLDG E",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295615",
            "telephone_number": "602-997-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11221 N 28TH DR BLDG E",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295615",
            "telephone_number": "602-997-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIM",
        "first_name": "MARVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "psychologist",
            "affiliation": "N",
            "endpointDescription": "psychologist",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11221 N 28th Dr Bldg E",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850295615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jigsaw Developmental Services LLC
• Princeton A Jiles
• Jill E Kerr, D. O. P.C.
• Jill R. Zweig D.O., PC
• Cephia Katherine Jim, RN
• Rochelle Yvonne Jim, R.N.
• Sallie Jim, PA-C
• Jimac LLC
• Jessica Cristina Jimenez Ramirez, PHD
• Leslie Fernanda Jimenez Terrazas

• Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.