Healthcare Provider Details
I. General information
NPI: 1922930536
Provider Name (Legal Business Name): JOHN MICHAEL PALMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
425 W LINCOLN ST APT 1
PAPILLION NE
68046-2511
US
IV. Provider business mailing address
425 W LINCOLN ST APT 1
PAPILLION NE
68046-2511
US
V. Phone/Fax
- Phone: 806-282-4916
- Fax:
- Phone: 806-282-4916
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315P00000X |
| Taxonomy | Intellectual Disabilities Intermediate Care Facility |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372600000X |
| Taxonomy | Adult Companion |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: