David I Proctor III, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31005755A Issued in IN

Practice address

2108 E Boulevard
Kokomo, IN 46902-2401

Phone

(765) 416-8480

NPI assigned

Dec 13, 2016

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1487198230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411169",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412330",
            "telephone_number": "888-883-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022401",
            "telephone_number": "765-416-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "DAVID",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-13",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005755A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Lynn Prifogle, MA, NCC, LMHC
• Edward Prince
• Mirikle Prince
• Lindsay Marie Pringle, RN, FNP-C
• Pro2 Kokomo, LLC
• Provider Partners Care Management Indiana LLC
• Psychotherapy Associates of Kokomo, LLC
• Shiloh Pullen
• Kushagra Pundir, MD
• Franklin Forest Purciful, PA

• Occupational Therapist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.