NPIMap

Proactive MD Ga, LLC

Organization Active NPI Primary Care Clinic/Center · Conley, GA

NPI 1265035877 · NPPES record last updated Aug 31, 2026

Key facts

NPI
1265035877
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
PROACTIVE MD GA, LLC
Practice address
3361 Grant Rd
Conley, GA 30288-2133
Phone
(678) 244-7933
NPI assigned
Nov 17, 2020
Organization subpart
No

Authorized official

Name
Mark Allen Kemble, MD
Title
Chief Medical Officer
Phone
(864) 640-8355

Corporate family (same tax ID) 2

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

Practitioners 2

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2201670Proactive MD-Tindall Conley Health Center
3361 Grant Road, Conley, GA 30288		Certificate of waiverNov 22, 2026

National Provider Directory

Tax ID family
Proactive MD Ga LLC (3 organizations share this tax ID)

Locations

3361 Grant Rd
Conley, GA 30288
Phone (678) 244-7933

Specialties & licenses

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

Addresses

Primary practice location

3361 Grant Rd
Conley, GA 30288-2133

Mailing address

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

Other names

  • Tindall Conley Health Center Doing business as

Other providers in Conley, GA

All providers in Conley, GA · Primary Care Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.