Individual provider Active NPI

Katie Lynn Palmer

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1407465750
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN277423 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-8071
NPI assigned
Jul 23, 2020
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN277423 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Blake 12 ICU
Boston, MA 02114-2621
Phone (617) 726-8071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210114002659 MA Practitioner - Nurse Practitioner 5991118713 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN277423MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Dec 6, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Dec 6, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#12
Boston, MA 02114
Phone (617) 724-9144

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1407465750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 12 ICU",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN277423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.