Active NPI
Karissa Marie Proctor, PHARM.D
- Pharmacist
- Conway, SC
National Provider Identifier
1437409547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13151
- Practice address
- 1610 Church St Ste U
Conway, SC 29526-2932 - Phone
- (843) 248-0505
- Fax
- (843) 381-0961
- NPI assigned
- Sep 17, 2012
- Last updated
- Sep 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13151 | SC | Primary |
Addresses
Primary practice location
1610 Church St Ste U
Conway, SC 29526-2932
Mailing address
1610 Church St Ste U
Conway, SC 29526-2932
Phone (843) 248-0505
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13151 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347840000000",
"number": "1437409547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1610 CHURCH ST STE U",
"city": "CONWAY",
"state": "SC",
"postal_code": "295262932",
"telephone_number": "843-248-0505",
"fax_number": "843-381-0961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 CHURCH ST STE U",
"city": "CONWAY",
"state": "SC",
"postal_code": "295262932",
"telephone_number": "843-248-0505",
"fax_number": "843-381-0961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "KARISSA",
"middle_name": "MARIE",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-17",
"last_updated": "2012-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "13151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
- Matthew Pressley
- Nathaniel Sebastain Pressley, BA
- Clinton Douglas Prevatte
- Jimmy Price, M.D.
- Proactive MD SC,P.a. (Proactive MD)
- Cole Prosser, DMD
- Melissa Courtney Prothro
- Proxsys RX - SC, LLC (The Pharmacy at CMC)
- PRS 5, LLC (Professional Rehabilitation Services)
- Pruitthealth - Conway, LLC (PruittHealth - Conway at Conway Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.