Theresa Victoria Proctor, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F01210028 Issued in MD

Practice address

11 Newburg Ave Ste 3
Catonsville, MD 21228-5172

Phone

(443) 207-0733

NPI assigned

Mar 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MD

  Medicare reassignment NPD
• Vital NP - Integrative Medicine & Wellness Services, LLC

  • Primary Care Clinic/Center
  • Catonsville, MD
  • NPI 1912884834
  NPD Authorized official

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1447845888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NEWBURG AVE STE 3",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285172",
            "telephone_number": "443-207-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NEWBURG AVE STE 3",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285172",
            "telephone_number": "443-207-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "THERESA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "F01210028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Privia Medical Group, LLC
• Process of Changes
• Process of Changes
• Process of Changes Inc
• Process of Changes Inc
• Cortney Jae Proutt, PHARMD
• Rudolf Pullmann, MD
• Purple Lantern Therapy, LLC
• Timothy Scott Putman, DPT
• Watio Crystal Joe Puwo Tameko

• Family Nurse Practitioner in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.