Organization Active NPI

Kyle L. Palmer, M.D., PLLC

  • Orthopaedic Surgery Physician
  • Meridian, ID
National Provider Identifier
1073720173
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M5987 Issued in ID
Legal business name
KYLE L. PALMER, M.D., PLLC
Practice address
3875 East Overland Road
Meridian, ID 83642
Phone
(208) 884-8300
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Dr. Kyle L Palmer, M.D.
Title
Owner
Phone
(208) 884-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X M5987 ID Primary

Addresses

Primary practice location

3875 East Overland Road
Meridian, ID 83642

Mailing address

3875 East Overland Road
Meridian, ID 83642
Phone (208) 884-8300

Other identifiers 1

IdentifierTypeStateIssuer
804142100MedicaidID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1073720173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 EAST OVERLAND ROAD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-884-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 EAST OVERLAND ROAD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-884-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE L. PALMER, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-884-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M5987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804142100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.