Powell Russ Proctor, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5012226 Issued in NC

Practice address

695 W Fleming Dr
Morganton, NC 28655-4450

Phone

(828) 580-3278

Fax

(828) 580-3279

NPI assigned

Sep 9, 2019

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, 213 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fast Pace Kentucky PLLC

  • Urgent Care Clinic/Center
  • Spindale, NC
  • NPI 1609634633
  Medicare reassignment Care Compare group NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Locust, NC
  • NPI 1144803040
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  NC

  Medicare reassignment NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Burlington, NC
  • NPI 1043170558
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1992354310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 W FLEMING DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554450",
            "telephone_number": "828-580-3278",
            "fax_number": "828-580-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 W FLEMING DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554450",
            "telephone_number": "828-580-3278",
            "fax_number": "828-580-3279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Malcolm Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Connelly Springs",
            "state": "NC",
            "postal_code": "286128079",
            "country_code": "US",
            "telephone_number": "828-874-4600",
            "fax_number": "828-874-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1208 Hickory Blvd SW Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lenoir",
            "state": "NC",
            "postal_code": "286456461",
            "country_code": "US",
            "telephone_number": "828-991-4660",
            "fax_number": "829-991-4659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2293 Sugar Hill Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "NC",
            "postal_code": "287527787",
            "country_code": "US",
            "telephone_number": "828-652-8727",
            "fax_number": "828-652-8793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "POWELL",
        "middle_name": "RUSS",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Practical Counseling Solutions, PLLC
• Michelle Louise Prell, PSY.D.
• Kim Rhyne Prewitt, LPCA
• Travis Howard Pritchard, LMBT, LRTA
• Nicholas Kyle Proctor, LCMHCA
• Ronnie Dwaine Proffitt
• Stephen P Prohaska, PA
• Brittany Propst
• Natalie Quach, OTR/L
• Quaker Meadows FCH - Burke Rest Home Inc

• Family Nurse Practitioner in Morganton, NC
• Providers in Morganton, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.