Individual provider Active NPI

William Jackson Palmer

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1073255378
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MT225671 Issued in PA
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

Updated by the provider on May 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510002901 PA Order and Referring Only - OtolaryngologyPractitioner - Otolaryngology 7911384003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT225671PAMDOtolaryngology 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

Verify at the official NPI Registry.