Melvin Bernard Palmer, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110003940 Issued in VA

Practice address

730 Thimble Shoals Blvd
Suite 130
Newport News, VA 23606-4562

Phone

(757) 873-1554

Fax

(757) 873-3239

NPI assigned

Jul 2, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mpalmer@hrosm.gwaydirect.com

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1669736971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 130",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554",
            "fax_number": "757-873-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 130",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064562",
            "telephone_number": "757-873-1554",
            "fax_number": "757-873-3239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5335 Discovery Park Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882696",
            "country_code": "US",
            "telephone_number": "757-253-0603",
            "fax_number": "757-585-7645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 Thimble Shoals Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064562",
            "country_code": "US",
            "telephone_number": "757-223-5700",
            "fax_number": "757-223-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "MELVIN",
        "middle_name": "BERNARD",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1669736971",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669736971",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1669736971",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE LICENSE",
            "identifier": "0110003940",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MEDICARE SUPPLEMENT",
            "identifier": "556062",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline A Page, MD
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• Sydni Taylor Paige
• Savannah Paladin
• Amudha Palani, MD
• Sytinenia Palmer
• Libby Palumbo
• Pamela Moran-Christner Professional Counseling Services
• Junmei Pan, PT
• Camelia Pana, MD

• Physician Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.