Individual provider Active NPI

Kesha Chanel Palmer

  • Registered Dietitian
  • Atlanta, GA
National Provider Identifier
1003748047
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD003725 Issued in GA
Practice address
2296 Henderson Mill Rd NE Ste 116
Atlanta, GA 30345-2739
Phone
(757) 652-6488
NPI assigned
Jun 2, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD003725 GA Primary

Addresses

Primary practice location

2296 Henderson Mill Rd NE Ste 116
Atlanta, GA 30345-2739

Mailing address

1711 Watford GLN
Lawrenceville, GA 30043-3078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LD003725GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Simple Faith Wellness LLC Dietitian, Registered Current Accepting new patients

Locations

2296 Henderson Mill Rd NE
Ste 116
Atlanta, GA 30345
Phone (404) 692-6907

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1003748047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 WATFORD GLN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE STE 116",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739",
            "telephone_number": "757-652-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KESHA",
        "middle_name": "CHANEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.