Active NPI
Thomas Justin Palmer, RN CRNP
- Primary Care Nurse Practitioner
- Mobile, AL
National Provider Identifier
1912200932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 1-096501
- Practice address
- 101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1786 - Phone
- (251) 414-5900
- Fax
- (251) 281-1162
- NPI assigned
- Dec 14, 2010
- Last updated
- Sep 15, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1-096501 | AL | Primary |
Addresses
Primary practice location
101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1786
Mailing address
101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1786
Phone (251) 414-5900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912200932 | Other | AL | NPI |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-096501 | AL | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1912200932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MEMORIAL HOSPITAL DR",
"address_2": "SUITE 200",
"city": "MOBILE",
"state": "AL",
"postal_code": "366081786",
"telephone_number": "251-414-5900",
"fax_number": "251-281-1162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MEMORIAL HOSPITAL DR",
"address_2": "SUITE 200",
"city": "MOBILE",
"state": "AL",
"postal_code": "366081786",
"telephone_number": "251-414-5900",
"fax_number": "251-281-1162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "THOMAS",
"middle_name": "JUSTIN",
"credential": "RN CRNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-14",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "AL",
"license": "1-096501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1912200932",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.