Organization Active NPI

Proctor Clinic PC

  • Chiropractor
  • Cartersville, GA
National Provider Identifier
1609064716
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIROOO514 Issued in GA
Legal business name
PROCTOR CLINIC PC
Practice address
1010 N Tennessee St
Suite 116
Cartersville, GA 30120-8525
Phone
(770) 383-9605
Fax
(770) 383-9606
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Dr. John William Proctor, D.C.
Title
President
Phone
(770) 383-9605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIROOO514 GA Primary

Addresses

Primary practice location

1010 N Tennessee St
Suite 116
Cartersville, GA 30120-8525

Mailing address

PO Box 200066
Cartersville, GA 30120-9002
Phone (770) 383-9605

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1609064716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200066",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301209002",
            "telephone_number": "770-383-9605",
            "fax_number": "770-383-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N TENNESSEE ST",
            "address_2": "SUITE 116",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208525",
            "telephone_number": "770-383-9605",
            "fax_number": "770-383-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCTOR CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-383-9605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIROOO514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.