Peter L Procko, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RNA113009 Issued in ME

Practice address

86208 Sand Hickory TRL
Yulee, FL 32097-4295

Phone

(904) 556-1404

NPI assigned

Dec 12, 2006

Last updated

Dec 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Doctor of Medicine

State licenses

Practice roles

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

• Anesthesia Health Care Partners of Florida Inc

  • Anesthesiology Physician
  • Orlando, FL
  • NPI 1518915545

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesiology Consultants of the Palm Beaches PA

  • Anesthesiology Physician
  • Wellington, FL
  • NPI 1720013287
  NPD (past)
• Bay Hospital, Inc.

  dba HCA Florida Gulf Coast Hospital Inpatient Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Panama City, FL
  • NPI 1093437733
  NPD (past)
• Ft. Walton Beach Anesthesia Services LLC

  • Anesthesiology Physician
  • Fort Walton Beach, FL
  • NPI 1245443829
  NPD (past)
• Heather Shaffer MD PA

  • Family Medicine Physician
  • Panama City, FL
  • NPI 1790877512
  NPD (past)
• Lake County Anesthesia Associates PA

  • Pain Medicine (Anesthesiology) Physician
  • Leesburg, FL
  • NPI 1033163464

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Peace River Anesthesiology Associates PA

  • Specialist
  • Punta Gorda, FL
  • NPI 1497737654
  NPD (past)
• Ahp of Central Georgia, PC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1972638047

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesiology of Greenwood PA

  • Anesthesiology Physician
  • Greenwood, SC
  • NPI 1932189081
  NPD (past)
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)
• South Georgia Regional Anesthesia, PC

  • Specialist
  • Valdosta, GA
  • NPI 1396763256
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1396805958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86208 SAND HICKORY TRL",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320974295",
            "telephone_number": "904-556-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86208 SAND HICKORY TRL",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320974295",
            "telephone_number": "904-556-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCKO",
        "first_name": "PETER",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN090565",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "3390",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA113009",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "RN090565",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "ARNP1961972",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00378017",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000559237L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Apple-Joe Pope
• Ashley Taylor Porter, CNM
• Stephen Conrad Potter, DDS
• Alexis Prescott
• James William Price, M.D.
• Progressus Therapy, LLC
• Emily Ann Pruitt, LMHC
• Publix Super Markets Inc (Publix Pharmacy #1406)
• Publix Super Markets, Inc (Publix Pharmacy #1792)
• Pulse Imaging LLC

• Certified Registered Nurse Anesthetist in Yulee, FL
• Providers in Yulee, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.