Charles Baldwin Procknow, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

110866 Issued in AK

Practice address

4951 Business Park Blvd
Anchorage, AK 99503-7174

Phone

(907) 743-7200

NPI assigned

Aug 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Family Practice

Education

Oregon Health Sciences University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anchorage Neighborhood Health Center IncGroup PAC ID 0941107288, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cprocknow498305@ak.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.

• Anchorage Neighborhood Health Center Inc

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1811170210
  Medicare reassignment Care Compare group NPD
• Anchorage Neighborhood Health Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
  • NPI 1184367195
  NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CP Ak HH, LLC

  • Home Health Agency
  • Anchorage, AK
  • NPI 1134941156
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1710310669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 E 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084372",
            "country_code": "US",
            "telephone_number": "907-562-9229",
            "fax_number": "907-561-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCKNOW",
        "first_name": "CHARLES",
        "middle_name": "BALDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "110866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1647283",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyche V Privett, REGISTERED NURSE
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• Pro Vision Anesthesia Services
• Procare Home Medical, Inc.
• Whitney Prochownik
• Naoko Proctor-Fajen, LMT
• Prodigy Medical, LLC
• Professional Care Service
• Programs for Infants & Children, Inc
• Programs for Infants & Children, Inc.

• Family Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.