Individual provider Active NPI

Christopher Alan Proctor, CNS, CRNFA

  • Registered Nurse
  • Bullhead City, AZ
National Provider Identifier
1356447262
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
281505 Issued in CA
Practice address
3454 Beale St
Bullhead City, AZ 86442-8621
Phone
(928) 763-1120
Fax
(775) 227-0014
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN087061 AZ
Registered Nurse 163W00000X 281505 CA Primary
Clinical Nurse Specialist 364S00000X AP1617 AZ

Addresses

Primary practice location

3454 Beale St
Bullhead City, AZ 86442-8621

Mailing address

3454 Beale St
Bullhead City, AZ 86442-8621
Phone (928) 763-1120

Other identifiers 1

IdentifierTypeStateIssuer
537590MedicaidAZ

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
RN087061AZMDRegistered Nurse
281505CAMDRegistered Nurse
AP1617AZMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Vein Institute LLC Past Accepting new patients
Arizona First Assistants 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1356447262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 BEALE ST",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428621",
            "telephone_number": "928-763-1120",
            "fax_number": "775-227-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 BEALE ST",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428621",
            "telephone_number": "928-763-1120",
            "fax_number": "775-227-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "CNS, CRNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN087061",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "281505",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "AZ",
            "license": "AP1617",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "537590",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.