Individual provider Active NPI

Dexter Raynard Palmer, DPT

  • Physical Therapist
  • Schertz, TX
National Provider Identifier
1558189175
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1399961 Issued in TX
Practice address
5700 Schertz Pkwy Ste 110
Schertz, TX 78154-1498
Phone
(210) 781-4810
NPI assigned
Oct 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1399961 TX Primary

Addresses

Primary practice location

5700 Schertz Pkwy Ste 110
Schertz, TX 78154-1498

Mailing address

PO Box 932184
Atlanta, GA 31193-2184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016003128 TX Practitioner - Physical Therapist in Private Practice 2961934831 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1399961TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Rehab Center Inc Physical Therapist CurrentSince Sep 27, 2024 Accepting new patients
Endeavor Rehab Center Inc Physical Therapist CurrentSince Sep 27, 2024 Accepting new patients

Locations

6911 Ranch Road 620 N
Austin, TX 78732
Phone (512) 219-8533

5632 Edwards Ranch Rd
Ft Worth, TX 76109
Phone (817) 259-0600

896 Summit St
Round Rock, TX 78664
Phone (512) 599-4262

5700 Schertz Pkwy
Ste 110
Schertz, TX 78154
Phone (210) 781-4810

110 Mary Lou Dr
Ste 100
Willow Park, TX 76087
Phone (817) 423-5611

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1558189175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 SCHERTZ PKWY STE 110",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781541498",
            "telephone_number": "210-781-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "DEXTER",
        "middle_name": "RAYNARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1399961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schertz, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.