Active NPI
Mark Stephen Palmer, DDS
- Dentist
- Laramie, WY
National Provider Identifier
1992002232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 893
- Practice address
- 204 McCollum Dr
Suite 103
Laramie, WY 82070-5103 - Phone
- (307) 745-5055
- NPI assigned
- Feb 23, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 893 | WY | Primary |
| Dentist | 122300000X | 6937 | CO |
Addresses
Primary practice location
204 McCollum Dr
Suite 103
Laramie, WY 82070-5103
Mailing address
PO Box 987
Laramie, WY 82073-0987
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6937 | CO | MD | Dentist |
| 893 | WY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298419200000",
"number": "1992002232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 987",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820730987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 MCCOLLUM DR",
"address_2": "SUITE 103",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705103",
"telephone_number": "307-745-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-23",
"last_updated": "2011-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WY",
"license": "893",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "6937",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.