Samuel Copeland Palmer IV, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

9485401 Issued in FL

Practice address

1220 University Blvd N
Jacksonville, FL 32211-8852

Phone

(904) 490-8700

Fax

(904) 490-9810

NPI assigned

Jul 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ez Health Medical Group PAGroup PAC ID 7214469816, 34 clinicians

Brooklyn Family Medicine Practice PCGroup PAC ID 7911401260, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.palmer@337577483108356.direct.elationemr.com

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.

• Brooklyn Family Medicine Practice PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1730972654

  FL

  Medicare reassignment Care Compare group NPD
• Ez Health Medical Group PA

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1790511442

  FL

  Medicare reassignment Care Compare group NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• American Advanced Practice Network, P.C.

  • Nurse Practitioner
  • Watertown, SD
  • NPI 1790244341

  FL

  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Lifemd Southern Patient Medical Care PC

  • Clinic/Center
  • Orlando, FL
  • NPI 1417635921

  Nurse Practitioner

  NPD
• Lifemd Atlantic Patient Medical Care PC

  • Clinic/Center
  • Hoboken, NJ
  • NPI 1164100657

  Nurse Practitioner

  NPD
• Lifemd Kansas Patient Medical Care PA

  • Clinic/Center
  • Overland Park, KS
  • NPI 1073353850

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1689014862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118852",
            "telephone_number": "904-490-8700",
            "fax_number": "904-490-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118852",
            "telephone_number": "904-490-8700",
            "fax_number": "904-490-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "SAMUEL",
        "middle_name": "COPELAND",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP017792",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LP-0000214",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308308",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9485401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Palmer, AP
• Kim Palmer, LPN
• Konasia Palmer, RBT
• Richard Irving Palmer
• Samuel Palmer, ARNP
• Scott Palmer, MD
• William Palmer, MD
• Mayelin Palmero Capote, APRN
• Maria Thereza Palmieri Barbosa, MD
• Francis X. Palmieri, MSW

• Adult Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.