Individual provider Active NPI

Martha Pickard Palmer

  • Nutritionist
  • Potsdam, NY
National Provider Identifier
1669870259
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
009728 Issued in NY
Practice address
49 Lawrence Ave
Potsdam, NY 13676-1889
Phone
(315) 261-5550
Fax
(315) 261-5559
NPI assigned
Dec 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 009728 NY Primary

Addresses

Primary practice location

49 Lawrence Ave
Potsdam, NY 13676-1889

Mailing address

49 Lawrence Ave
Potsdam, NY 13676-1889
Phone (315) 261-5550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190410000323 NY Practitioner - Registered Dietitian Or Nutrition Professional 4183965643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

49 Lawrence Ave
Potsdam, NY 13676-1889
Phone (315) 261-5550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009728NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Potsdam Hospital Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1669870259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 LAWRENCE AVE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761889",
            "telephone_number": "315-261-5550",
            "fax_number": "315-261-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 LAWRENCE AVE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761889",
            "telephone_number": "315-261-5550",
            "fax_number": "315-261-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD PALMER",
        "first_name": "MARTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "009728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.