Active NPI
Andrea Suzanne Proctor, NP
- Family Nurse Practitioner
- Nashville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10456
- Practice address
- 402 22ND Ave N
Nashville, TN 37203-1949 - Phone
- (615) 251-8805
- NPI assigned
- Jun 13, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024185100 | VA | |
| Family Nurse Practitioner | 363LF0000X | 10456 | TN | Primary |
Addresses
Primary practice location
402 22ND Ave N
Nashville, TN 37203-1949
Mailing address
5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611
Phone (615) 994-1000
Other practice location 1
5511 Virginia Way
STe 300
Brentwood, TN 37027-7611
Phone (615) 994-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1512 Hatcher LN
Columbia, TN 38401-4825
Phone (931) 548-8882
170 Blevins Blvd
Bristol, VA 24202-6021
Phone (276) 285-3911
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024185100 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedar Recovery Center of Middle Tennessee, LLC | Current | Accepting new patients | |
| Cedar Recovery of Middle Tennessee, LLC | Current | Accepting new patients |
Locations
1512 Hatcher Ln
Columbia, TN 38401
Phone (615) 257-6844
2636 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 680-0110
5000 Crossings Cir
Ste 103
Mt Juliet, TN 37122
Phone (615) 208-9549
170 Blevins Blvd
Bristol, VA 24202
Phone (276) 285-3911
Organizations & group practices 2
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.
-
- Addiction Medicine (Preventive Medicine) Physician
- Columbia, TN
- NPI 1801345285
VA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1659864650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5511 VIRGINIA WAY",
"address_2": "STE 300",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277611",
"telephone_number": "615-994-1000",
"fax_number": "615-994-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 22ND AVE N",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031949",
"telephone_number": "615-251-8805"
}
],
"practiceLocations": [
{
"address_1": "5511 Virginia Way",
"address_2": "STe 300",
"address_purpose": "LOCATION",
"city": "Brentwood",
"state": "TN",
"postal_code": "370277611",
"country_code": "US",
"telephone_number": "615-994-1000",
"fax_number": "615-994-0100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PROCTOR",
"first_name": "ANDREA",
"middle_name": "SUZANNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-13",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024185100",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "10456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.