Active NPI
Richard A Proctor, MD
- Infectious Disease Physician
- Madison, WI
National Provider Identifier
1376504282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 20338
- Practice address
- 600 Highland Ave
Madison, WI 53792 - Phone
- (608) 263-0943
- Fax
- (608) 263-9103
- NPI assigned
- Mar 30, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 20338 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792
Mailing address
8007 Excelsior Dr
Madison, WI 53717
Phone (608) 829-5201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30187300 | Medicaid | WI |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20338 | WI | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1376504282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8007 EXCELSIOR DR",
"city": "MADISON",
"state": "WI",
"postal_code": "53717",
"telephone_number": "608-829-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "53792",
"telephone_number": "608-263-0943",
"fax_number": "608-263-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "RICHARD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "WI",
"license": "20338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30187300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.