Active NPI
Phillip Burl Palmer, P.T.
- Physical Therapist
- Dahlonega, GA
National Provider Identifier
1770799900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1504
- Practice address
- 82 College Circle
North Georgia College & State University
Dahlonega, GA 30597 - Phone
- (706) 864-1469
- Fax
- (706) 864-1493
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1016434 | TX | |
| Physical Therapist | 225100000X | 1504 | GA | Primary |
Addresses
Primary practice location
82 College Circle
North Georgia College & State University
Dahlonega, GA 30597
Mailing address
221 Yahoola Shoals Dr
Dahlonega, GA 30533-7508
Phone (706) 864-1469
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1504 | GA | MD | Optometrist |
| 1016434 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285200000000",
"number": "1770799900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 YAHOOLA SHOALS DR",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305337508",
"telephone_number": "706-864-1469",
"fax_number": "706-864-1493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 COLLEGE CIRCLE",
"address_2": "NORTH GEORGIA COLLEGE & STATE UNIVERSITY",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "30597",
"telephone_number": "706-864-1469",
"fax_number": "706-864-1493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "PHILLIP",
"middle_name": "BURL",
"name_prefix": "Dr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2010-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1016434",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "1504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dahlonega, GA
- Northview Orthopaedic Surgery Center, P.C.
- Mohammad Reza Nourbakhsh, DPT
- NVW Newco, LLC
- Cindy L Orr, PHARMD
- Stefanie Dean Dismer Palma, PT, DPT
- Micaela Pamplin, PHARMD
- Brian Andrew Parker, NP
- Pathology Consultants of Georgia (PCG Molecular)
- Patrick a Conarro MD (d.b.a. Summit Surgical ASC)
- Patrick a. Conarro, M.D. (Summit Surgical)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.