Individual provider Active NPI

Ronald Maclean Palmer, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1366869513
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
578144 Issued in TX
Practice address
3437 W 7TH St
Fort Worth, TX 76107-2718
Phone
(817) 688-1588
NPI assigned
Mar 26, 2014
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 578144 TX
Gerontology Nurse Practitioner 363LG0600X 578144 TX Primary

Addresses

Primary practice location

3437 W 7TH St
Fort Worth, TX 76107-2718

Mailing address

1048 Wildwood Dr
Joshua, TX 76058-6197
Phone (817) 798-5447

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141222000251 TX Practitioner - Nurse Practitioner 8820311996 Reassigns benefits to 1 organization
Practice locations: Grapevine, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gerination Medical Centers LLCGroup PAC ID 4486961661, 2 clinicians

Practice addresses (Care Compare)

3708 Clarke Ave
Fort Worth, TX 76107-2634
Phone (817) 688-1588

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
15.21 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
50.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
578144TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Concepts Inc Past Accepting new patients
Perfect Peace Health Consultants PLLC Past Accepting new patients
Questcare Matrix, PLLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1366869513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 WILDWOOD DR",
            "city": "JOSHUA",
            "state": "TX",
            "postal_code": "760586197",
            "telephone_number": "817-798-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 W 7TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072718",
            "telephone_number": "817-688-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "RONALD",
        "middle_name": "MACLEAN",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "578144",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "578144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.