Individual provider Active NPI

Kevin V Palmer, M.D.

  • Surgery Physician
  • Brooksville, FL
National Provider Identifier
1821064460
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0070806 Issued in FL
Practice address
11373 Cortez Blvd
Suite 201
Brooksville, FL 34613-5414
Phone
(352) 596-7860
Fax
(352) 597-3657
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0070806 FL Primary

Addresses

Primary practice location

11373 Cortez Blvd
Suite 201
Brooksville, FL 34613-5414

Mailing address

14690 Spring Hill Dr
Suite 100 Attn:Credentialing
Spring Hill, FL 34609-8102
Phone (352) 799-0046

Other identifiers 3

IdentifierTypeStateIssuer
31269OtherFLBCBS
379988300MedicaidFL
P00955956OtherFLRR MCR ATTACHED TO GRP# DR6927

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
ME0070806FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Surgical Associates Surgery CurrentSince Jul 27, 2005 Accepting new patients
Access Healthcare LLC Past Accepting new patients
John Parrinello, PA PastSince Sep 1, 2006 Accepting new patients
Fawzi Soliman MD PA Surgery PastSince Aug 16, 2013 Accepting new patients

Locations

7515 State Road 52
Ste 102
Hudson, FL 34667
Phone (727) 842-3322

11373 Cortez Blvd
Ste 201
Spring Hill, FL 34613
Phone (352) 596-7860

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1821064460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14690 SPRING HILL DR",
            "address_2": "SUITE 100 ATTN:CREDENTIALING",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098102",
            "telephone_number": "352-799-0046",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11373 CORTEZ BLVD",
            "address_2": "SUITE 201",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135414",
            "telephone_number": "352-596-7860",
            "fax_number": "352-597-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KEVIN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0070806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31269",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379988300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR ATTACHED TO GRP# DR6927",
            "identifier": "P00955956",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.