Individual provider Active NPI

Courtney Gillis Palmer, LISW

  • Social Worker
  • Des Moines, IA
National Provider Identifier
1841286804
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
06392 Issued in IA
Practice address
2353 SE 14TH St
Des Moines, IA 50320-1109
Phone
(515) 248-1400
Fax
(515) 248-1414
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 06392 IA Primary

Addresses

Primary practice location

2353 SE 14TH St
Des Moines, IA 50320-1109

Mailing address

1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447

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

State licenses

LicenseStateTypeSpecialty
06392IAMDSocial Worker
06395IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1841286804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201109",
            "telephone_number": "515-248-1400",
            "fax_number": "515-248-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS PALMER",
        "first_name": "COURTNEY",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.