Active NPI
William Jackson Palmer
- Otolaryngology Physician
- Philadelphia, PA
National Provider Identifier
1073255378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MT225671
- Practice address
- 925 Chestnut St FL 6
Philadelphia, PA 19107-4204 - Phone
- (215) 955-6760
- Fax
- (215) 503-3736
- NPI assigned
- Apr 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Otolaryngology Physician | 207Y00000X | MT225671 | PA | Primary |
Addresses
Primary practice location
925 Chestnut St FL 6
Philadelphia, PA 19107-4204
Mailing address
925 Chestnut St FL 6
Philadelphia, PA 19107-4204
Phone (215) 955-6784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220510002901 | PA | Order and Referring Only - Otolaryngology | 7911384003 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT225671 | PA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651449600000",
"number": "1073255378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 CHESTNUT ST FL 6",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074204",
"telephone_number": "215-955-6784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 CHESTNUT ST FL 6",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074204",
"telephone_number": "215-955-6760",
"fax_number": "215-503-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "WILLIAM",
"middle_name": "JACKSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-08",
"last_updated": "2022-05-02",
"certification_date": "2022-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "PA",
"license": "MT225671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.