NPIMap

Organization Active NPI

Proactive MD SC,P.a.

Doing business as Proactive MD Percival

  • Primary Care Clinic/Center
  • Columbia, SC
National Provider Identifier
1083433130
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROACTIVE MD SC,P.A.
Doing business as
Proactive MD Percival
Practice address
4101 Percival Rd
Columbia, SC 29229-8320
Phone
(864) 501-0751
NPI assigned
Oct 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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) 640-8355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4101 Percival Rd
Columbia, SC 29229-8320

Mailing address

86 Villa Rd Ste 100
Greenville, SC 29615-3052
Phone (864) 640-8355

Other names 1

  • Proactive MD Percival Doing business as

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
42D2312454Proactive MD Percival Health Center4101 Percival Rd, Columbia, SC 29229Certificate of waiverOct 10, 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

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1083433130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 VILLA RD STE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153052",
            "telephone_number": "864-640-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 PERCIVAL RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298320",
            "telephone_number": "864-501-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD SC,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "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": "864-640-8355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proactive MD Percival",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive MD Percival",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.