Proactive MD NM, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROACTIVE MD NM, LLC

Doing business as

Proactive MD SONM Santa Fe Health Center

Practice address

1100 S Saint Francis Dr Ste 1000
Santa Fe, NM 87505-4147

Phone

(864) 501-0751

NPI assigned

Feb 9, 2022

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

Chief Medical Officer

Phone

(864) 640-8355

Specialties & licenses 1

Addresses

Other names 1

• Proactive MD SONM Santa Fe Health Center Doing business as

Tax ID family

Proactive MD NM LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Proactive MD NM, LLC

  • Primary Care Clinic/Center
  • Artesia, NM
  • NPI 1205416732
  NPD tax ID
• Proactive MD NM, LLC

  • Primary Care Clinic/Center
  • Greenville, SC
  • NPI 1700465002
  NPD tax ID

Locations

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1407500309",
    "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": "1100 S SAINT FRANCIS DR STE 1000",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054147",
            "telephone_number": "864-501-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD NM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "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": "CHIEF MEDICAL OFFICER",
        "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 SONM Santa Fe Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elizabeth T Prishkulnik, DDS
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• Rafal Proban, M.D.
• Tamara Prochorchik
• Christina Procter, LMSW
• Professional Dental Care of Northern New Mexico I Professional
• Professional Dental Care PLLC

• Primary Care Clinic/Center in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Primary Care Clinic/Center in New Mexico

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.