Active NPI
Anne Marie Palmitier, P.T.
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1962409086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501010954
- Practice address
- 4761 Lake Michigan Dr NW
Suite a
Grand Rapids, MI 49534-6300 - Phone
- (616) 975-9078
- Fax
- (616) 975-9248
- NPI assigned
- Jul 5, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010954 | MI | Primary |
Addresses
Primary practice location
4761 Lake Michigan Dr NW
Suite a
Grand Rapids, MI 49534-6300
Mailing address
4586 Lytham Dr
Hudsonville, MI 49426-8987
Phone (616) 975-9078
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P33910F | Other | MI | BLUE CARE NETWORK |
| 20--0223019 | Other | MI | TAX ID |
| 650D114040 | Other | MI | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010954 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1962409086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4586 LYTHAM DR",
"city": "HUDSONVILLE",
"state": "MI",
"postal_code": "494268987",
"telephone_number": "616-975-9078",
"fax_number": "616-975-9248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4761 LAKE MICHIGAN DR NW",
"address_2": "SUITE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495346300",
"telephone_number": "616-975-9078",
"fax_number": "616-975-9248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMITIER",
"first_name": "ANNE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P33910F",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "20--0223019",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "650D114040",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.