Angela M Proctor

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

6431 Old Branch Ave
Temple Hills, MD 20748-2607

Phone

(202) 903-7616

NPI assigned

Mar 6, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Newman'S Bodyshop Personal Training Inc.

  • Athletic Trainer
  • Temple Hills, MD
  • NPI 1639532617

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1861027245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 WIND RIDGE DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225544795",
            "telephone_number": "240-401-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 OLD BRANCH AVE",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207482607",
            "telephone_number": "202-903-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "ANGELA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Temple Hills, MD
• Providers in Temple Hills, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.