Jeremy A Proctor, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2524 Issued in WV

Practice address

1464 Jefferson St N
Lewisburg, WV 24901-1380

Phone

(304) 645-3220

Fax

(304) 645-4103

NPI assigned

Aug 20, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV, ME2 enrollments

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 2

Specialty

Emergency Medicine

Education

West Virginia School of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Merit-based Incentive Payment System (MIPS)

Final score

96.58 of 100Reported as apm

Quality

83.17

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jproctor2517426@direct.bsmhealth.org

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.

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment Care Compare group NPD
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Emergency Medicine Services of Maine, LLC

  • Emergency Medicine Physician
  • Ellsworth, ME
  • NPI 1578032058
  Medicare reassignment NPD
• Charleston Area Medical Center, Inc.

  • Hospitalist Physician
  • Ronceverte, WV
  • NPI 1972125995

  Emergency Medicine

  NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD

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

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1285866467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "304-645-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 JEFFERSON ST N",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011380",
            "telephone_number": "304-645-3220",
            "fax_number": "304-645-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "JEREMY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "DO3504",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023389",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorene Prazak Cooper, FNP-BC
• Cheri Presock
• Silas Mason Preston Jr.
• Jessica Price
• Angel Ann Pritt
• Psychconsultmd
• Stephanie Puckett
• Dorris A Ragsdale, MD
• Rainelle Medical Center, Inc
• Rainelle Medical Center, Inc

• Family Medicine Physician in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.