Proactive Pain and Neurology, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

PROACTIVE PAIN AND NEUROLOGY, LLC

Practice address

921 Seton Dr
Cumberland, MD 21502-1852

Phone

(240) 522-0098

Fax

(240) 522-0099

NPI assigned

Nov 9, 2017

Last updated

Dec 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dennis Daniel Dey, MDNPI 1972546364

Title

Owner

Phone

(240) 522-0098

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Tax ID family

Proactive Pain Neurology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Proactive Pain and Neurology, LLC

  dba Proactive Primary Care

  • Primary Care Nurse Practitioner
  • Cumberland, MD
  • NPI 1669037008
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GAACBD

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dennis Daniel Dey, MD

  • Neurology Physician
  • Cumberland, MD
  • NPI 1972546364

  Multi-Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Christeena Brown, CRNP

  • Nurse Practitioner
  • Hagerstown, MD
  • NPI 1164963963
  Medicare reassignment Care Compare group NPD
• Greta J Cain, CRNP

  • Family Nurse Practitioner
  • Cumberland, MD
  • NPI 1215363080
  Medicare reassignment Care Compare group NPD
• Anika Mansfield, FNP-C

  • Family Nurse Practitioner
  • Cumberland, MD
  • NPI 1518715598
  Medicare reassignment Care Compare group NPD
• Denise V Wilson, CRNP

  • Registered Nurse
  • Lavale, MD
  • NPI 1255370524
  Medicare reassignment Care Compare group NPD
• Rachel Leigh Jacovino, CRNP

  • Family Nurse Practitioner
  • Cumberland, MD
  • NPI 1871846873
  NPD (past)

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1417460619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011602",
            "telephone_number": "240-522-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 SETON DR",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021852",
            "telephone_number": "240-522-0098",
            "fax_number": "240-522-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PAIN AND NEUROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "DEY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-522-0098",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D0062211",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999023200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "006632753",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "630051",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "DL77",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Elisa Price, PA-C
• Primary Care Practitioners, LLC
• Michelle Printy, LCSW-C
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Proactive Pain and Neurology, LLC (Proactive Primary Care)
• Professional Dental Alliance of Maryland, LLC
• Professional Dental Alliance of Meridian, PLLC
• Joan Proietti, LCSW-C
• Diana Dawn Pryor, DNP

• Neurology Physician in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Neurology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.