Kyle Palmer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5916 Issued in ID

Practice address

621 Main St Ste a
Lewiston, ID 83501-1871

Phone

(509) 769-7551

NPI assigned

May 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Performance Physio PLLC

  • Physical Therapy Clinic/Center
  • Lewiston, ID
  • NPI 1073097390
  Medicare reassignment NPD Authorized official
• Knelsen Twin Rivers Physical Therapy

  • Physical Therapist
  • Clarkston, WA
  • NPI 1013669852
  NPD (past)

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699203455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 18TH AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994033014",
            "telephone_number": "509-780-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MAIN ST STE A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011871",
            "telephone_number": "509-769-7551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 6th St",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "WA",
            "postal_code": "994032006",
            "country_code": "US",
            "telephone_number": "509-758-8510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2022-07-21",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60736008",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Overcomer Christian Counseling
• Steven Edwin Ozeran, MD
• Pacific Cataract and Laser Institute, Inc., P.C.
• David C Pakula, MD
• Patrick Palkowski, MS, LAT, ATC
• Jacob Pannell
• Sushma Pant, MD
• Michael K Parent, MD
• Melissa Lee Park, MD
• Leanne Parker, PHD

• Physical Therapist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.