Organization Active NPI

Palmer Chiropractic Life Center, Inc

  • Chiropractor
  • New Castle, DE
National Provider Identifier
1154629079
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F1-0000268 Issued in DE
Legal business name
PALMER CHIROPRACTIC LIFE CENTER, INC
Practice address
1 Pleasant PL
New Castle, DE 19720-3005
Phone
(302) 328-2656
Fax
(302) 328-5870
NPI assigned
Mar 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Timothy S Palmer, DCNPI 1598812067
Title
Owner
Phone
(302) 328-2656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X F1-0000268 DE Primary

Addresses

Primary practice location

1 Pleasant PL
New Castle, DE 19720-3005

Mailing address

1 Pleasant PL
New Castle, DE 19720-3005
Phone (302) 328-2656

Other identifiers 3

IdentifierTypeStateIssuer
1154629079MedicaidDE
1598812067MedicaidDE
561525OtherMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111129000338 DE Part B Supplier - Clinic/Group Practice 2668646787 Receives reassigned benefits from 2 practitioners
Practice locations: New Castle, DE

National Provider Directory

National Provider Directory

Locations

191 Christiana Rd
Ste 1
New Castle, DE 19720
Phone (302) 322-1794

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1154629079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PLEASANT PL",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197203005",
            "telephone_number": "302-328-2656",
            "fax_number": "302-328-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLEASANT PL",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197203005",
            "telephone_number": "302-328-2656",
            "fax_number": "302-328-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER CHIROPRACTIC LIFE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-328-2656",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154629079",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598812067",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "561525",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.