Active NPI
Courtney S Palmer, D.P.M.
- Podiatrist
- Annapolis, MD
National Provider Identifier
1205830122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 00542
- 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, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1401421 | Other | MD | CIGNA |
| 1565-0001 | Other | MD | CAREFIRST BCBS DC, FED |
| T195 | Other | MD | CAREFIRST BCBS MD |
| 219575 | Other | MD | MAMSI |
| 258908700 | Medicaid | MD | |
| 08400 | Other | MD | AMERIGROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Podiatry LLC | Podiatrist | Current | Accepting new patients |
| Podiatry Group- Hebrew Home | Podiatrist | Past | Accepting new patients |
| D & P, LLC | Past | 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.
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- NPI 1629430111
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- Podiatrist
- Rockville, MD
- NPI 1104910462
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.