Krystal Leigh Palmer

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905479 Issued in MS

Practice address

1415 College Dr
Meridian, MS 39307-5345

Phone

(601) 483-4821

NPI assigned

Dec 25, 2019

Sex

Female

Sole proprietor

Yes

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 MS

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Region Ten State of MsGroup PAC ID 4284605353, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Region Ten Commission State of Ms

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, MS
  • NPI 1073626511
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1770122657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10101 Road 1719",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "MS",
            "postal_code": "393507312",
            "country_code": "US",
            "telephone_number": "601-663-4412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KRYSTAL",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-25",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "870496",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• P&P Counseling Services Meridian Branch
• Rolanda T Pace, DNP, APRN,BC
• Gena Paige, L.H.I.S
• Pain Management Ctr Meridian
• Pain Partners, LLC
• Panoramic Care
• Adam M Parker, M.D.
• Alisha Smith Parker, D.O.
• Jordan Parker
• Katie Nichole Parker

• Family Nurse Practitioner in Meridian, MS
• Providers in Meridian, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.