Active NPI
Benjamin Alex Proctor, PHARMD
- Pharmacist
- Windsor, CO
National Provider Identifier
1952954885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22728
- Practice address
- 1535 Main St
Windsor, CO 80550-5993 - Phone
- (970) 674-1188
- NPI assigned
- Jul 19, 2019
- Last updated
- Jul 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22728 | CO | Primary |
Addresses
Primary practice location
1535 Main St
Windsor, CO 80550-5993
Mailing address
7733 W 55TH Ave Apt 306
Arvada, CO 80002-4510
Phone (720) 394-1169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22728 | Other | CO | PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22728 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563494400000",
"number": "1952954885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7733 W 55TH AVE APT 306",
"city": "ARVADA",
"state": "CO",
"postal_code": "800024510",
"telephone_number": "720-394-1169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 MAIN ST",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805505993",
"telephone_number": "970-674-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "BENJAMIN",
"middle_name": "ALEX",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-19",
"last_updated": "2019-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "22728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "22728",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CO
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Elizabeth Poulin-Rodriguez, MS, LMFT
- Belinda Pribesh, LPC
- Private Healthcare Facilities
- Matthew John Ptaszkiewicz, M. D.
- Pure Intentions Counseling LLC
- Claire Quintero, LMT
- Quorum Orthopedics, Inc
- Caitlin V Raaz, PHD, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.