Monja L Proctor, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

J7836 Issued in TX

Practice address

4102 22ND PL
Lubbock, TX 79410-1122

Phone

(806) 725-0237

Fax

(806) 725-1030

NPI assigned

Oct 25, 2006

Last updated

Aug 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904
  Medicare reassignment NPD
• Covenant Medical Group

  dba Covenant Family Healthcare Center

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895
  NPD
• Methodist Children's Hospital

  dba Covenant Children's Hospital

  • Children's Hospital
  • Lubbock, TX
  • NPI 1437171568
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1023192747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101122",
            "telephone_number": "806-725-0237",
            "fax_number": "806-725-1030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Madison St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041307",
            "country_code": "US",
            "telephone_number": "206-215-2700",
            "fax_number": "206-215-2702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MONJA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WA",
            "license": "MD00041914",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "ND",
            "license": "PT13389",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "J7836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Kennedy Prieto, M.D.
• Elaine Prince
• Michael Matthew Pringle, PA-C
• Patrick Pritchett, RPH
• Karla Privett, LCSW
• Professional Eyewear
• Professional Home Detox
• Professional Opticians, L.L.C.
• Jennifer Anne Proffitt, PA-C
• Progressive Counseling Services

• Pediatric Surgery Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatric Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.