Christina Ballyncy Proctor, M.ED

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

9218 Wolcott Park LN
Houston, TX 77075-3824

Phone

(713) 298-4785

NPI assigned

Jan 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1396496568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "832-464-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9218 WOLCOTT PARK LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770753824",
            "telephone_number": "713-298-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "CHRISTINA",
        "middle_name": "BALLYNCY",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAM ID",
            "identifier": "MSS1RKLREBU8",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jacory Aungi Proctor
• Rebekah E Proctor, MD
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• Prodigy Medride LLC
• Jesse Morrow Proett, M.D.

• Early Intervention Provider Agency in Houston, TX
• Providers in Houston, TX by specialty
• Early Intervention Provider Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.