Active NPI
Sally Proctor, RPH
- Pharmacist
- Fairfax, VA
National Provider Identifier
1508575929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202009649
- Practice address
- 3600 Joseph Siewick Dr
Fairfax, VA 22033-1709 - Phone
- (703) 391-3080
- NPI assigned
- Nov 15, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 0202009649 | VA | Primary |
Addresses
Primary practice location
3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Mailing address
8617 Oak Chase Cir
Fairfax Sta, VA 22039-3331
Phone (571) 215-9808
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202009649 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1508575929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8617 OAK CHASE CIR",
"city": "FAIRFAX STA",
"state": "VA",
"postal_code": "220393331",
"telephone_number": "571-215-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 JOSEPH SIEWICK DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331709",
"telephone_number": "703-391-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "SALLY",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-15",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202009649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.