Individual provider Active NPI

Wesley Palmer, M.D.

  • Family Medicine Physician
  • Jbphh, HI
National Provider Identifier
1770692642
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-11551 Issued in HI
Practice address
480 Central Ave BLDG 1750
Jbphh, HI 96860-4908
Phone
(808) 474-4242
Fax
(808) 471-0918
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TPME4933 FL
Family Medicine Physician 207Q00000X 0392 MP
Family Medicine Physician 207Q00000X MD-11551 HI Primary

Addresses

Primary practice location

480 Central Ave BLDG 1750
Jbphh, HI 96860-4908

Mailing address

480 Central Ave BLDG 1750
Jbphh, HI 96860-4908
Phone (808) 474-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TPME4933FLMDFamily Medicine Physician
0392MPMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: wesley.palmer.1@19917.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1770692642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE BLDG 1750",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-474-4242",
            "fax_number": "808-471-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE BLDG 1750",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-474-4242",
            "fax_number": "808-471-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "WESLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TPME4933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MP",
            "license": "0392",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-11551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.