Individual provider Active NPI

Gregg V Palmer, LPN

  • Licensed Practical Nurse
  • Tacoma, WA
National Provider Identifier
1609239375
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
VN210175 Issued in CA
Practice address
17TH and C Street
BLDG 11582
Tacoma, WA 98431
Phone
(253) 966-7647
NPI assigned
Mar 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X VN210175 CA Primary

Addresses

Primary practice location

17TH and C Street
BLDG 11582
Tacoma, WA 98431

Mailing address

4948 Balustrade Blvd SE
Lacey, WA 98513-4168
Phone (801) 550-7633

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

LicenseStateTypeSpecialty
VN210175CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1609239375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 BALUSTRADE BLVD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985134168",
            "telephone_number": "801-550-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17TH AND C STREET",
            "address_2": "BLDG 11582",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-966-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "GREGG",
        "middle_name": "V",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "VN210175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.