Individual provider Active NPI

Samuel E. Palmer, M.D.

  • Family Medicine Physician
  • Bonaire, GA
National Provider Identifier
1083663348
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
029061 Issued in GA
Practice address
106 Moran Drive
Bonaire, GA 31005
Phone
(478) 988-1282
Fax
(478) 988-3120
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 029061 GA Primary

Addresses

Primary practice location

106 Moran Drive
Bonaire, GA 31005

Mailing address

106 Moran Drive
Bonaire, GA 31005
Phone (478) 988-1282

Other identifiers 2

IdentifierTypeStateIssuer
000374382KMedicaidGA
00374382I OR EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000567 GA Practitioner - Family Practice 0244219392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samuel E. Palmer, MD, PCGroup PAC ID 3870563034, 2 clinicians

Practice addresses (Care Compare)

106 Moran Dr
Bonaire, GA 31005-5106
Phone (478) 988-1282

Hospital & facility affiliations

  • Amedisys Home Health of Macon Home health agency, Macon, GA, CCN 117093
  • Enhabit Home Health Home health agency, Macon, GA, CCN 117152
  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
029061GAMDFamily Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJCBD/Endpoint/BBJCBD

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1083663348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MORAN DRIVE",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-988-1282",
            "fax_number": "478-988-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MORAN DRIVE",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-988-1282",
            "fax_number": "478-988-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "SAMUEL",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "029061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000374382K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00374382I OR E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

Verify at the official NPI Registry.