Individual provider Active NPI

Kelly Palmer

  • Obstetrics & Gynecology Physician
  • Austin, TX
National Provider Identifier
1174027668
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
T4447 Issued in TX
Practice address
1007 E 41St St
Austin, TX 78751-4809
Phone
(512) 451-3131
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 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
Obstetrics & Gynecology Physician 207V00000X T4447 TX Primary

Addresses

Primary practice location

1007 E 41St St
Austin, TX 78751-4809

Mailing address

1007 E 41St St
Austin, TX 78751-4809
Phone (512) 451-3131

Other practice location 1

2401 S 31st St
Ms-01-E316A
Temple, TX 76508-0001
Phone (254) 724-7588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220802000926 TX Practitioner - Obstetrics/Gynecology 4183971450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Davids Healthcare Partnership, L.P., LLP Past Accepting new patients
Austin OB-GYN Associates PA Obstetrics & Gynecology Past Accepting new patients

Organizations & group practices 2

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1174027668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 E 41ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514809",
            "telephone_number": "512-451-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E 41ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514809",
            "telephone_number": "512-451-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_2": "MS-01-E316A",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "T4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.