Individual provider Active NPI

Kaitlin Annettte Palermo, FNP-C

  • Family Nurse Practitioner
  • Bay City, TX
National Provider Identifier
1801354170
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140889 Issued in TX
Practice address
111 Avenue F
Bay City, TX 77414-4117
Phone
(979) 245-2008
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP140889 TX Primary

Addresses

Primary practice location

111 Avenue F
Bay City, TX 77414-4117

Mailing address

101 Avenue F N
Bay City, TX 77414-3167
Phone (979) 245-2008

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190514002726 TX Practitioner - Nurse Practitioner 3678816667 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matagorda Episcopal Health Outreach Program CurrentSince Apr 8, 2019 Accepting new patients
Matagorda Episcopal Health Outreach Program Corporation CurrentSince Apr 8, 2019 Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients
Matagorda Episcopal Health Outreach Program PastSince Aug 25, 2019 Accepting new patients

Locations

101 Avenue F N
Bay City, TX 77414

111 Avenue F
Bay City, TX 77414
Phone 9792452008300

111 Avenue F N
Bay City, TX 77414
Phone 9792452008302

1700 Golden Ave
Bay City, TX 77414

307 Green Ave
Ste A
Palacios, TX 77465
Phone 9792452008300

2112 Regional Medical Dr
Ste 1313
Wharton, TX 77488
Phone 9792452008300

Interoperability endpoints

  • Direct secure messaging: kaitlin.palermo.1@17406.direct.athenahealth.com

Organizations & group practices 4

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1801354170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE F N",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143167",
            "telephone_number": "979-245-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 AVENUE F",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774144117",
            "telephone_number": "979-245-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "KAITLIN",
        "middle_name": "ANNETTTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, TX

Sources for this page

Verify at the official NPI Registry.