Joseph William Proctor

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071005721 Issued in IL

Practice address

210 S Randolph St
Macomb, IL 61455-3828

Phone

(217) 779-6063

NPI assigned

Apr 2, 2017

Sex

Male

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  IL, Psychologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491091200000",
    "number": "1497287007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6482 LAKESHORE VIEW DR",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626814707",
            "telephone_number": "217-779-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S RANDOLPH ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553828",
            "telephone_number": "217-779-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-02",
        "last_updated": "2017-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071005721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Powell, ANP
• John Robert Prain, CADC
• Robert William Price III, DMD
• Pridemore Chiropractic Center, Inc
• Thomas Jefferson Pridemore Jr., D.C.
• Julissa Rabe
• Andrea Marie Ratermann, RN, IL-CSN
• Darrell Ratermann, RPH
• Larry Dean Rawlins, LCPC
• Melanie E. Rawlins, PHD

• Psychologist in Macomb, IL
• Providers in Macomb, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2017; 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.