Individual provider Active NPI

Kareemah Palace Parker

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1093201204
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN006088 Issued in PA
Practice address
1331 E Wyoming Ave
Philadelphia, PA 19124-3808
Phone
(215) 707-1622
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN006088 PA Primary
Lactation Consultant (Non-RN) 174N00000X L-163149 PA

Addresses

Primary practice location

1331 E Wyoming Ave
Philadelphia, PA 19124-3808

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Other practice location 1

750 Beech Ave
Glenolden, PA 19036-1104
Phone (267) 968-8580

Other practice location 2

150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1725
Phone (800) 203-8657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180816001247 PA Practitioner - Registered Dietitian Or Nutrition Professional 7517216013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN006088PAMDRegistered Dietitian
L-163149PAMDLactation Consultant (Non-RN)

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1093201204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-707-1622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Beech Ave",
            "address_purpose": "LOCATION",
            "city": "Glenolden",
            "state": "PA",
            "postal_code": "190361104",
            "country_code": "US",
            "telephone_number": "267-968-8580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Monument Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190041725",
            "country_code": "US",
            "telephone_number": "800-203-8657",
            "fax_number": "800-258-1426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KAREEMAH",
        "middle_name": "PALACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006088",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "PA",
            "license": "L-163149",
            "primary": false
        }
    ],
    "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 Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.