Proactive Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROACTIVE PHYSICAL THERAPY

Practice address

812 Lyndon LN Ste 101
Louisville, KY 40222-3844

Phone

(812) 406-6854

Fax

(502) 792-7283

NPI assigned

Dec 31, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Brandon Evans, PT, DPTNPI 1922634237

Title

Owner

Phone

(812) 406-6854

Specialties & licenses 1

Addresses

Other names 1

• ProActive Physical Therapy and Wellness Other name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon Evans, PT, DPT

  • Physical Therapist
  • Lyndon, KY
  • NPI 1922634237
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Abdo, DPT

  • Physical Therapist
  • Lyndon, KY
  • NPI 1346921293
  Medicare reassignment Care Compare group NPD
• Emily Evans, DPT

  • Physical Therapist
  • Louisville, KY
  • NPI 1225553241
  Medicare reassignment NPD

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1255929691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 SPRUCE GROVE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993380",
            "telephone_number": "812-406-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 LYNDON LN STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223844",
            "telephone_number": "812-406-6854",
            "fax_number": "502-792-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-31",
        "last_updated": "2024-01-05",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-406-6854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProActive Physical Therapy and Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melody Prinkleton, PT, DPT
• Privatus Medical PLLC
• Pro Client Solutions, LLC
• Pro2 Louisville, LLC
• Proactive MD Ky PSC
• Proapex
• Mary Katherine Schmoll Probst, PHARMD
• Michael Wayne Probst, RPH
• Shaun Probst, PHARMD
• Linda Probus

• Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.