Keishaun Saschier Proctor, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

67962 Issued in GA

Practice address

3695 Cascade Rd SW Ste S
Atlanta, GA 30331-2146

Phone

(404) 699-1339

NPI assigned

Apr 30, 2009

Sex

Female

Sole proprietor

No

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1720080989
  Medicare reassignment NPD
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • McDonough, GA
  • NPI 1982489555
  NPD

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1952545287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 CASCADE RD SW STE S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312146",
            "telephone_number": "404-699-1339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "868 York Ave SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303102750",
            "country_code": "US",
            "telephone_number": "404-752-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "KEISHAUN",
        "middle_name": "SASCHIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "67962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proactive Medical Training Center Inc
• Procare Pharmacy, LLC
• Procrown Prosthetics
• Charles Daniel Procter Jr., MD
• Kaitlin Baker Proctor, PHD
• Kennedi Proctor, RBT
• Prodigy Therapeutic Solutions LLC
• Professional Care, Inc.
• Professional Counseling Center of Atlanta, LLC
• Professional Dental Alliance of Atlanta Boulevard SE, LLC

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.

Verify at the official NPI Registry.