Kevin Samuel Proctor, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501016460 Issued in MI

Practice address

350 N Main St
Suite 180
Chelsea, MI 48118-1370

Phone

(734) 475-9925

Fax

(734) 475-9927

NPI assigned

Aug 27, 2013

Last updated

Jan 8, 2018By the provider in NPPES

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

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.

• Physical Therapy Services of West Michigan LLC

  • Physical Therapist
  • Kalamazoo, MI
  • NPI 1508895806

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1508290529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 CHICAGO DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233004",
            "telephone_number": "616-796-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N MAIN ST",
            "address_2": "SUITE 180",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181370",
            "telephone_number": "734-475-9925",
            "fax_number": "734-475-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "KEVIN",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501016460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Martin Portz, M.D.
• Emine Poyraz, MD
• Elizabeth Prast, DDS
• Precision Spinal Care, PLLC
• Proactive Chiropractic
• Julia Marie Pudar, MD
• Barbara Jane Putman, CPNP-PC
• Christopher Scott Putnam, PT
• Kelly Quinn-Kelly, CCC-SLP
• Jenna Quinn, LMSW

• Orthopedic Physical Therapist in Chelsea, MI
• Providers in Chelsea, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.