Mary Kathryn Proctor, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R140050 Issued in MD

Practice address

9135 Piscataway Rd
Suite 420
Clinton, MD 20735-2549

Phone

(301) 868-2555

NPI assigned

Oct 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

G Medicine LLCGroup PAC ID 5496811903, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Largo, MD, CCN 217149
• Medstar Health Home Care Home health agency, Hyattsville, MD, CCN 217150
• Homecall Home health agency, Easton, MD, CCN 217066

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5761/brand/1/csg/1/fhir/r4

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

• G Medicine LLC

  • Internal Medicine Physician
  • Clinton, MD
  • NPI 1376790428

  DC

  Medicare reassignment Care Compare group NPD
• Patricia G Gao MD LLC

  • Clinic/Center
  • Glen Burnie, MD
  • NPI 1518159888
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Homecall, LLC

  • Home Health Agency
  • Easton, MD
  • NPI 1700971843
  Care Compare affiliation Name & address match
• Amedisys Home Health of Maryland, LLC

  • Home Health Agency
  • Largo, MD
  • NPI 1831143908
  Care Compare affiliation
• Medstar Health Visiting Nurse Association, Inc.

  • Home Health Agency
  • Greenbelt, MD
  • NPI 1154437879
  Care Compare affiliation

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1144779158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD",
            "address_2": "SUITE 420",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352549",
            "telephone_number": "301-868-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD",
            "address_2": "SUITE 420",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352549",
            "telephone_number": "301-868-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R140050",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R140050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prince George'S County Health Department
• Prince George'S Health Department
• Dexter E. Pritchettt
• Privia Medical Group, LLC
• Privium Consultants LLC
• Proflex Physical Therapy of Maryland, LLC
• Psychiatric and Medical Patient Care
• Philip Fei Qui, D.D.S.
• R-Sik Healthcare Services LLC
• Adam Michael Rabe, DO

• Family Nurse Practitioner in Clinton, MD
• Providers in Clinton, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.