Individual provider Active NPI

Christopher J Palmer, OD

  • Optometrist
  • Inver Grove Heights, MN
National Provider Identifier
1366593162
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2513 Issued in MN
Practice address
6175 Cahill Ave
Inver Grove Heights, MN 55076-5501
Phone
(651) 455-1492
Fax
(651) 455-9466
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2513 MN Primary

Addresses

Primary practice location

6175 Cahill Ave
Inver Grove Heights, MN 55076-5501

Mailing address

19515 Jamestown St NE
East Bethel, MN 55092-8535
Phone (612) 423-4403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110715000556 MN Practitioner - Optometry 0648448779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher P. Gregg CurrentSince May 1, 2023 Accepting new patients
Pham-Vang Optometry LLC Optometrist Past Accepting new patients
Christopher Peter Gregg Past Accepting new patients
Dr. Bruce Lebert OD Optometrist PastSince Oct 2, 2022 Accepting new patients

Locations

6175 Cahill Ave
Ste 101
Inver Grove Heights, MN 55076
Phone (651) 455-1492

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1366593162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19515 JAMESTOWN ST NE",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550928535",
            "telephone_number": "612-423-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 CAHILL AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550765501",
            "telephone_number": "651-455-1492",
            "fax_number": "651-455-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

Verify at the official NPI Registry.