NPIMap

Organization Active NPI

Proactive MD SC,P.a.

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1033716253
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROACTIVE MD SC,P.A.
Practice address
2273 Hayne St.
Spartanburg, SC 29301
Phone
(864) 541-0555
Fax
(864) 345-7898
NPI assigned
Oct 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Allen Kemble, MD
Title
Cmo
Phone
(864) 501-0751

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

2273 Hayne St.
Spartanburg, SC 29301

Mailing address

10 Centimeters Dr
Mauldin, SC 29662-3278

Other names 1

  • Proactive MD Tindall Spartanburg Health Center Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL 864-345-7898 Health Information Exchange (HIE) Proactive MD
Other URL 864-345-7898 Health Information Exchange (HIE)

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2122625Proactive MD Tindall Corporation2273 Hayne Street, Spartanburg, SC 29301Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Proactive MD Scpa19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

2273 Hayne St
Spartanburg, SC 29301
Phone (864) 541-0555

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1033716253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTIMETERS DR",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 HAYNE ST.",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29301",
            "telephone_number": "864-541-0555",
            "fax_number": "864-345-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD SC,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "KEMBLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "864-501-0751",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "864-345-7898",
            "affiliation": "Y",
            "endpointDescription": "EMR Fax",
            "affiliationName": "Proactive MD",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2273 Hayne St.",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "864-345-7898",
            "affiliation": "N",
            "endpointDescription": "EMR Fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2273 Hayne St.",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Proactive MD Tindall Spartanburg Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.