Individual provider Active NPI

Courtney S Palmer, D.P.M.

  • Podiatrist
  • Annapolis, MD
National Provider Identifier
1205830122
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00542 Issued in MD
Practice address
168 West St
Annapolis, MD 21401-2824
Phone
(410) 573-1111
Fax
(410) 573-1377
NPI assigned
Jun 9, 2005
Last updated
Sep 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00542 MD Primary

Addresses

Primary practice location

168 West St
Annapolis, MD 21401-2824

Mailing address

168 West St
Annapolis, MD 21401-2824
Phone (410) 573-1111

Other identifiers 6

IdentifierTypeStateIssuer
1401421OtherMDCIGNA
1565-0001OtherMDCAREFIRST BCBS DC, FED
T195OtherMDCAREFIRST BCBS MD
219575OtherMDMAMSI
258908700MedicaidMD
08400OtherMDAMERIGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090225000567 MD Practitioner - Podiatry 4385673128 Practice locations: Annapolis, MD
I20090413000045 DC Practitioner - Podiatry 4385673128 Practice locations: Glenarden, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Podiatry LLC Podiatrist CurrentSince Jan 1, 2023 Accepting new patients
Podiatry Group- Hebrew Home Podiatrist Past Accepting new patients
D & P, LLC PastSince Dec 22, 1994 Accepting new patients

Locations

107 Ridgely Ave
Ste 13A
Annapolis, MD 21401
Phone (443) 332-2300

168 West St
Annapolis, MD 21401
Phone (410) 573-1111

7940 Johnson Ave
Glenarden, MD 20706
Phone (301) 261-8112

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1205830122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 WEST ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012824",
            "telephone_number": "410-573-1111",
            "fax_number": "410-573-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 WEST ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012824",
            "telephone_number": "410-573-1111",
            "fax_number": "410-573-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "COURTNEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "00542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1401421",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS DC, FED",
            "identifier": "1565-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS MD",
            "identifier": "T195",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "219575",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258908700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "08400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.