NPIMap

Individual provider Active NPI

Marley Palmer

  • Nurse Practitioner
  • Great Bend, KS
National Provider Identifier
1518695261
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-82224-021 Issued in KS
Practice address
1021 Eisenhower Ave
Great Bend, KS 67530-3213
Phone
(620) 792-5437
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-82224-021 KS Primary
Registered Nurse 163W00000X 89757 NE

Addresses

Primary practice location

1021 Eisenhower Ave
Great Bend, KS 67530-3213

Mailing address

911 W 13TH St
Larned, KS 67550-1907
Phone (620) 804-3377

Other practice location 1

713 W 11th St
Larned, KS 67550-2055
Phone (620) 804-6007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814003643 KS Practitioner - Nurse Practitioner 1557723152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pawnee Valley Community Hospital IncGroup PAC ID 7315856473, shared by 5 NPIs, 11 clinicians

Practice addresses (Care Compare)

713 W 11TH St
Larned, KS 67550-2055
Phone (620) 804-6007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.72 of 100Reported as apm
Quality
68.82
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89757NEMDRegistered Nurse
53-82224-021KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Associates Current Accepting new patients
St. Joseph Memorial Hospital, Inc. Past Accepting new patients

Locations

713 W 11th St
Larned, KS 67550
Phone (620) 285-6958

Organizations & group practices 5

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 4

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": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1518695261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 W 13TH ST",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675501907",
            "telephone_number": "620-804-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 EISENHOWER AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303213",
            "telephone_number": "620-792-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 W 11th St",
            "address_purpose": "LOCATION",
            "city": "Larned",
            "state": "KS",
            "postal_code": "675502055",
            "country_code": "US",
            "telephone_number": "620-804-6007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "MARLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2023-10-31",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-82224-021",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "89757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.