Proactive MD NC, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROACTIVE MD NC, PC

Practice address

251 Eaton Rd
Mocksville, NC 27028-8653

Phone

(864) 501-0751

NPI assigned

Jan 18, 2023

Organization subpart

No

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

Addresses

Other names 1

• Proactive MD - Brakebush Health Center - Mocksville Doing business as

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

CLIA laboratory certificates

Tax ID family

Lee Industries Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Proactive MD NC, PC

  • Family Medicine Physician
  • Conover, NC
  • NPI 1013518166
  NPD tax ID
• Proactive MD NC, PC

  • Primary Care Clinic/Center
  • Fayetteville, NC
  • NPI 1578200028
  NPD tax ID
• Proactive MD NC, PC

  • Primary Care Clinic/Center
  • Greenville, SC
  • NPI 1417521857
  NPD tax ID

Locations

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1154036713",
    "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": "251 EATON RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270288653",
            "telephone_number": "864-501-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD NC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "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 - Brakebush Health Center - Mocksville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive MD - Brakebush Health Center - Mocksville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pine Forrest Farm Inc
• Shamika Yolanda Pompey, MSW, LCSW-A
• John Naylor Price, MD
• Gary Edward Prillaman, DDS
• Hannah Prillaman, LCMHCA
• PS Senior Living of Mocksville LLC
• Demetri Psihogios, PHARMD
• Virginia Randall
• Rebel Care Counseling & Wellness, PLLC
• William O Renfroe, MD

• Primary Care Clinic/Center in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.