Active NPI
Courtney Proctor
- Women's Health Nurse Practitioner
- Costa Mesa, CA
National Provider Identifier
1083958870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 22352
- Practice address
- 601 W 19TH St
Costa Mesa, CA 92627-5060 - Phone
- (714) 922-4100
- NPI assigned
- Nov 16, 2012
- Last updated
- Nov 16, 2012
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 22352 | CA | Primary |
Addresses
Primary practice location
601 W 19TH St
Costa Mesa, CA 92627-5060
Mailing address
601 West 19TH St
Costa Mesa, CA 92627
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22352 | CA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KMG Medical Group Mo, P.C. | Past | Accepting new patients | |
| Michael Karagas, M.D., P.C. D/B/a/ KMG Medical Group | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- San Francisco, CA
- NPI 1740788702
-
- Family Medicine Physician
- Lexington, KY
- NPI 1730844085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1083958870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 WEST 19TH ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W 19TH ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926275060",
"telephone_number": "714-922-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-16",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "22352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
- George Presko, M.S., LCSW
- Cynthia Preston, N.D.
- Primary Healthcare Medical Group Ipa Inc
- Kevin Christer Pripp
- Procare Health, Inc.
- Produce to People, Inc.
- Progressive Physical Therapy and Rehabilitation Inc
- Prohealth Partners a Medical Group Inc
- Proof Positive ABA Therapies
- Propoint Sports Acupuncture Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.