Active NPI
John H. Proctor, M.D.
- Emergency Medicine Physician
- Nashville, TN
National Provider Identifier
1679511471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20700
- Practice address
- 391 Wallace Rd
Nashville, TN 37211-4851 - Phone
- (615) 781-4000
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20700 | TN | Primary |
Addresses
Primary practice location
391 Wallace Rd
Nashville, TN 37211-4851
Mailing address
PO Box 634706
Cincinnati, OH 45263-0001
Phone (865) 292-3000
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3051994 | Other | TN | BLUECROSS |
| 3052176 | Medicaid | TN | |
| 3159791 | Other | TN | BLUECROSS |
| P00220920 | Other | TN | RAILROAD MEDICARE |
| 000000076048 | Other | KY | BLUECROSS |
| 00019934 | Medicaid | MS | |
| 3077695 | Other | TN | BLUECROSS |
| P00332581 | Other | TN | RAILROAD MEDICARE |
| 3052175 | Medicaid | TN | |
| 64798630 | Medicaid | KY | |
| 3052177 | Medicaid | TN | |
| 5M197 | Other | AR | BLUECROSS |
| P00248226 | Other | TN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20700 | TN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Services of Memphis, P.C. | Emergency Medicine | Past | Accepting new patients |
| Southeastern Emergency Services P C | Past | Accepting new patients | |
| Acs Primary Care Physicians of Arkansas PA | Emergency Medicine | Past | Accepting new patients |
| Southeastern Emergency Physicians of Memphis LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194825600000",
"number": "1679511471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 634706",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452630001",
"telephone_number": "865-292-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 WALLACE RD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372114851",
"telephone_number": "615-781-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "JOHN",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2007-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TN",
"license": "20700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "3051994",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3052176",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "3159791",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00220920",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "000000076048",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00019934",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "3077695",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00332581",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3052175",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64798630",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3052177",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "5M197",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00248226",
"state": "TN"
}
],
"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 Nov 12, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.