Individual provider Active NPI

James Robert Palmer III, DC

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1700405925
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013112 Issued in IL
Practice address
4821 Lansing Ave
Jackson, MI 49201-8241
Phone
(517) 750-7790
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301011021 MI
Chiropractor 111N00000X 038.013112 IL Primary

Addresses

Primary practice location

4821 Lansing Ave
Jackson, MI 49201-8241

Mailing address

863 S Perryville Rd
Rockford, IL 61108-4328
Phone (779) 423-2044

Other practice location 1

863 S Perryville Rd
Rockford, IL 61108-4328
Phone (779) 423-2044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210731000359 MI Practitioner - Chiropractic 0244634038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

833 Laurence Ave
Suite B
Jackson, MI 49202-2981
Phone (517) 750-7790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013112ILMDChiropractor
2301011021MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hands for Life Jackson Chiropractor Current Accepting new patients
Palmer Family Chiropractic Chiropractor CurrentSince Mar 25, 2021 Accepting new patients
Integrative Medical of Rockford PastSince Apr 1, 2020 Accepting new patients

Locations

833 Laurence Ave
Ste B
Jackson, MI 49202
Phone (517) 750-7790

4821 Lansing Ave
Jackson, MI 49201
Phone (517) 750-7790

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1700405925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 S PERRYVILLE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084328",
            "telephone_number": "779-423-2044",
            "fax_number": "779-423-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4821 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018241",
            "telephone_number": "517-750-7790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "863 S Perryville Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611084328",
            "country_code": "US",
            "telephone_number": "779-423-2044",
            "fax_number": "779-423-2045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-04-16",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301011021",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.