Active NPI
Antonio Palomba, LMSW
- Social Worker
- Jackson, MI
National Provider Identifier
1275640393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801017914
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 788-4730
- Fax
- (517) 788-4701
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801017914 | MI | Primary |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
PO Box 67000
Department 272801
Detroit, MI 48267-2728
Phone (517) 841-6913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801017914 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275640393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67000",
"address_2": "DEPARTMENT 272801",
"city": "DETROIT",
"state": "MI",
"postal_code": "482672728",
"telephone_number": "517-841-6913",
"fax_number": "517-841-6917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-788-4730",
"fax_number": "517-788-4701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALOMBA",
"first_name": "ANTONIO",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801017914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.