Active NPI
Kirk Palmer
- Clinical Social Worker
- Victor, NY
National Provider Identifier
1245349901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 050423-1
- Practice address
- 6532 Anthony Dr Ste a
Victor, NY 14564-1403 - Phone
- (585) 924-2100
- NPI assigned
- Aug 29, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 050423-1 | NY | Primary |
Addresses
Primary practice location
6532 Anthony Dr Ste a
Victor, NY 14564-1403
Mailing address
6532 Anthony Dr Ste a
Victor, NY 14564-1403
Phone (585) 924-2100
Other practice location 1
1331 East Victor Rd
Victor, NY 14564
Phone (585) 924-2100
Other practice location 2
1331 East Victor Rd
Victor, NY 14564
Phone (585) 924-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115985FK | Other | NY | PREFERRED CARE |
| P010050423 | Other | NY | EXCELLUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050423-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1245349901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6532 ANTHONY DR STE A",
"city": "VICTOR",
"state": "NY",
"postal_code": "145641403",
"telephone_number": "585-924-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6532 ANTHONY DR STE A",
"city": "VICTOR",
"state": "NY",
"postal_code": "145641403",
"telephone_number": "585-924-2100"
}
],
"practiceLocations": [
{
"address_1": "1331 East Victor Rd",
"address_purpose": "LOCATION",
"city": "Victor",
"state": "NY",
"postal_code": "14564",
"country_code": "US",
"telephone_number": "585-924-2100",
"fax_number": "585-924-5920",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1331 East Victor Rd",
"address_purpose": "LOCATION",
"city": "Victor",
"state": "NY",
"postal_code": "14564",
"country_code": "US",
"telephone_number": "585-924-2100",
"fax_number": "585-924-5920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PALMER",
"first_name": "KIRK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "050423-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "115985FK",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "P010050423",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.