Individual provider Active NPI

Robert M Palmer, O.D.

  • Optometrist
  • Montgomery City, MO
National Provider Identifier
1497936553
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2346 Issued in MO
Practice address
215 S Sturgeon St
Ste a
Montgomery City, MO 63361-2558
Phone
(573) 564-3877
Fax
(573) 564-3515
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO2346 MO Primary

Addresses

Primary practice location

215 S Sturgeon St
Ste a
Montgomery City, MO 63361-2558

Mailing address

215 S Sturgeon St
Ste a
Montgomery City, MO 63361-2558
Phone (573) 564-3877

Other identifiers 2

IdentifierTypeStateIssuer
108637OtherMOANTHEM BCBS
MO2346OtherMOEYEMED VISION CARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO2346MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Consultants Optometry Optometrist PastSince Jul 9, 2008 Accepting new patients

Organizations & group practices 1

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": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1497936553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S STURGEON ST",
            "address_2": "STE A",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633612558",
            "telephone_number": "573-564-3877",
            "fax_number": "573-564-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S STURGEON ST",
            "address_2": "STE A",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633612558",
            "telephone_number": "573-564-3877",
            "fax_number": "573-564-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "108637",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "MO2346",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.