Proactive Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

000029202N1,,N2,N6 Issued in OR

Legal business name

PROACTIVE HEALTH LLC

Practice address

62968 O B Riley Rd
#16
Bend, OR 97703-9442

Phone

(541) 389-8714

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Susan Hart, NP

Title

Director

Phone

(541) 389-8714

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1194912808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62968 O B RILEY RD",
            "address_2": "E2-16",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977039442",
            "telephone_number": "541-389-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62968 O B RILEY RD",
            "address_2": "#16",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977039442",
            "telephone_number": "541-389-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-389-8714",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "000029202N1,,N2,N6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Nicole Priestley
• Elizabeth Prieto
• John Vincent Prignano, PH.D.
• Jason Prinster, PH.D.
• Pro Motion Physical Therapy of Bend
• Kristen Prochaska, MA, LPC
• Kristyn Renee Prockish, PMHNP
• Professionals Choice Medical Supplies and Special Transport
• Program Design Concepts, Inc
• Promotion Physical Therapy

• Clinic/Center in Bend, OR
• Providers in Bend, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.