NPIMap

Individual provider Active NPI

Erin L Proctor, PA-C

  • Physician Assistant
  • Caldwell, ID
National Provider Identifier
1811987076
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-515 Issued in ID
Practice address
315 E. Elm Ste. 100
Caldwell, ID 83605-4858
Phone
(208) 459-7415
Fax
(208) 453-3307
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 515 ID
Physician Assistant 363A00000X PA-515 ID Primary

Addresses

Primary practice location

315 E. Elm Ste. 100
Caldwell, ID 83605-4858

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170

Other identifiers 1

IdentifierTypeStateIssuer
807034000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000540 ID Practitioner - Physician Assistant 5193775104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1075 N Curtis Rd
Boise, ID 83706-1350
Phone (208) 302-2000

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 515IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant CurrentSince Dec 21, 2009 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 21, 2009 Accepting new patients
Orthopedic & Fracture Clinic PA CurrentSince Oct 12, 2005 Accepting new patients
Richard Lochhead MD PLLC PastSince Jul 1, 2015 Accepting new patients
Gooding County Hospital District Past Accepting new patients

Locations

1075 N Curtis Rd
Ste 200
Boise, ID 83706
Phone (208) 323-0031

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1906 Fairview Ave
Ste 400
Caldwell, ID 83605
Phone (208) 287-6627

315 E Elm St
Ste 20
Caldwell, ID 83605

315 E Elm St
Ste 100
Caldwell, ID 83605
Phone (208) 302-7100

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

Interoperability endpoints

  • Direct secure messaging: eproctor1563955@direct.trinity-health.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1811987076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E. ELM STE. 100",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054858",
            "telephone_number": "208-459-7415",
            "fax_number": "208-453-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "ERIN",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA 515",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807034000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.