Individual provider Active NPI

Clo Ann Palmer, CRNA

  • Licensed Practical Nurse
  • New Hudson, MI
National Provider Identifier
1861624629
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
220017 Issued in TX
Practice address
28060 Tremonte Dr
New Hudson, MI 48165-8000
Phone
(248) 918-9558
NPI assigned
Aug 12, 2009
Last updated
Aug 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 220017 TX Primary

Addresses

Primary practice location

28060 Tremonte Dr
New Hudson, MI 48165-8000

Mailing address

28060 Tremonte Dr
New Hudson, MI 48165-8000

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
220017TXMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bayou City Anesthesia Group Past Accepting new patients
Anesthesiology Consultants of Houston PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1861624629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28060 TREMONTE DR",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28060 TREMONTE DR",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658000",
            "telephone_number": "248-918-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "CLO ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "220017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hudson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.