Brian Lowell Proctor, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2018020641 Issued in MO

Practice address

404 N Keene St
Columbia, MO 65201-6626

Phone

(573) 882-4438

Fax

(573) 884-9992

NPI assigned

Jul 3, 2018

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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

83.73 of 100Reported as group

Quality

80.23

Promoting interoperability

82

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bproctor612455@wm.providencedirect.org

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.

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Medicare reassignment NPD
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Medicare reassignment NPD
• Grays Harbor Community Hospital

  dba GHCH Westport Clinic

  • Clinic/Center
  • Westport, WA
  • NPI 1497510333
  NPD
• Prosser Public Hospital District of Benton County

  dba Benton City Clinic

  • Rural Health Clinic/Center
  • Benton City, WA
  • NPI 1437199072
  NPD
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health Spine Clinic

  • Specialist
  • Walla Walla, WA
  • NPI 1518770155
  NPD
• GHCH Physician Services, LLC

  dba Harbor Medical Group

  • Surgery Physician
  • Aberdeen, WA
  • NPI 1326217670

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1659867596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "BRIAN",
        "middle_name": "LOWELL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018020641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Supported Living LLC
• Alaina Prince, MD
• Hannah Elizabeth Prince, LCSW
• Melissa Deanne Princivalli, PMHNP
• Lauren Clough Pringle, MD
• Mariah Proctor
• Proctors Provision LLC.
• Lori A Proe, D.O.
• Professional Accounting Services for Optometry
• Professional Imaging Columbia, LLC

• Pediatrics Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.

Verify at the official NPI Registry.