Active NPI
Khadija Palmer
- Nursing Care Agency
- Bronx, NY
National Provider Identifier
1497031090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 7436141
- Practice address
- 3924 E Tremont Ave
Bronx, NY 10465-2900 - Phone
- (718) 409-6500
- NPI assigned
- Oct 26, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 7436141 | NY | Primary |
Addresses
Primary practice location
3924 E Tremont Ave
Bronx, NY 10465-2900
Mailing address
3924 East Tremont Avenue
Bronx, NY 10465
Phone (718) 409-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8564 | Other | NY | SOCIAL SECURITY NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7436141 | NY | MD | Nursing Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319587200000",
"number": "1497031090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3924 EAST TREMONT AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "10465",
"telephone_number": "718-409-6500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3924 E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104652900",
"telephone_number": "718-409-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "KHADIJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-26",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "NY",
"license": "7436141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL SECURITY NUMBER",
"identifier": "8564",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.