MICHAEL DOUGLAS PROCTOR NPI 1619740115

NPI Information

  • NPI: 1619740115
  • Provider Name: MICHAEL DOUGLAS PROCTOR
  • Classification: Technician - 3747P1801X
  • Specialization: Personal Care Attendant
  • Entity Type: Individual
  • Address: 4142 TAYLORS RIDGE RD
    PROCTOR, WV
    ZIP 26055
  • Phone: (304) 842-9887

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NPI Details

Michael Douglas Proctor is a personal care attendant technician in Proctor, WV. The provider is an individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards Michael Douglas Proctor NPI is 1619740115. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4142 TAYLORS RIDGE RD
PROCTOR, WV
ZIP 26055-241
Phone: (304) 842-9887

The enumeration date for this NPI number is 11/6/2023 and was last updated on 11/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13747P1801XTechnicianPersonal Care AttendantYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11821206228MEDICAIDWEST VIRGINIA
21356607394MEDICAIDWEST VIRGINIA
3125553494MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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