David N Procknow, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD16495 Issued in OR

Practice address

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1257

Phone

(541) 471-3455

NPI assigned

Nov 30, 2006

Last updated

Dec 30, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siskiyou Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
  • NPI 1427046903
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1780752782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257",
            "telephone_number": "541-471-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCKNOW",
        "first_name": "DAVID",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD16495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028642",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Preston
• Kenneth Pricer, RN, BSN
• Prime Physical Therapy
• Zackeria RL Privett, PSS
• Pro Physical Therapy LLC (Pro Physical Therapy)
• Providence Health & Services - Oregon (Providence Medical Group South)
• Debra Pruyn, LCSW, QMHP
• Shanna Pugh, PA-C
• Russ Pulliam
• Lance Christopher Pursley, LAC, MAOM

• Emergency Medicine Physician in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.