Active NPI
Brendan Edward Palm, ATC, CSCS
- Athletic Trainer
- Ridley Park, PA
National Provider Identifier
1861956351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1 S Stewart Ave
Ridley Park, PA 19078-1002 - Phone
- (856) 906-3224
- NPI assigned
- Jan 29, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1 S Stewart Ave
Ridley Park, PA 19078-1002
Mailing address
10 E Close
Moorestown, NJ 08057-2747
Phone (856) 906-3224
Other practice location 1
700 S High St
West Chester, PA 19383-0003
Phone (610) 436-1000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558915200000",
"number": "1861956351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 E CLOSE",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080572747",
"telephone_number": "856-906-3224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 S STEWART AVE",
"city": "RIDLEY PARK",
"state": "PA",
"postal_code": "190781002",
"telephone_number": "856-906-3224"
}
],
"practiceLocations": [
{
"address_1": "700 S High St",
"address_purpose": "LOCATION",
"city": "West Chester",
"state": "PA",
"postal_code": "193830003",
"country_code": "US",
"telephone_number": "610-436-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PALM",
"first_name": "BRENDAN",
"middle_name": "EDWARD",
"credential": "ATC, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-29",
"last_updated": "2019-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridley Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.