Palmer Mobile Medical, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PALMER MOBILE MEDICAL, LLC

Practice address

10146 Salt Aire Cir
Venice, FL 34292-2282

Phone

(330) 415-4473

NPI assigned

Feb 20, 2020

Last updated

Feb 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Copeland Palmer, APRN

Title

Managing Member

Phone

(330) 415-4473

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1174156905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10146 SALT AIRE CIR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922282",
            "telephone_number": "330-415-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10146 SALT AIRE CIR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922282",
            "telephone_number": "330-415-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER MOBILE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "COPELAND",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "330-415-4473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Business",
            "affiliation": "N",
            "endpointDescription": "Business address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10146 Salt Aire Cir",
            "city": "Venice",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342922282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• P Dee G Stephenson MD PA
• Ann Peggy Padiken
• Logan Michael Page, OD
• Patrick Page, M.D.
• Jordan Estuardo Palma, DPT
• Kalin Palmer, MS, LMHC
• Palmetto Court Alf of Venice, Inc
• Palmetto Home Health, LLC
• Colleen E Panza, CRNP
• Richard D Paolillo, MD

• Exclusive Provider Organization in Venice, FL
• Providers in Venice, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.