NPIMap

Organization Active NPI

Proactive MD SC,P.a.

Doing business as Proactive MD City of Spartanburg Health Center-City Hall

  • Primary Care Clinic/Center
  • Spartanburg, SC
National Provider Identifier
1619535978
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROACTIVE MD SC,P.A.
Doing business as
Proactive MD City of Spartanburg Health Center-City Hall
Practice address
145 W Broad St
Spartanburg, SC 29306-3210
Phone
(864) 596-2988
Fax
(864) 336-2948
NPI assigned
Jun 3, 2019
Last updated
Apr 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Mark Allen Kemble, MD
Title
Cmo
Phone
(864) 501-0751

Specialties & licenses 1

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

Addresses

Primary practice location

145 W Broad St
Spartanburg, SC 29306-3210

Mailing address

124 Allawood CT
Simpsonville, SC 29681-6207
Phone (864) 501-0751

Other names 1

  • Proactive MD City of Spartanburg Health Center-City Hall Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Proactive MD Scpa19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

145 W Broad St
Spartanburg, SC 29306
Phone (864) 596-2988

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1619535978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ALLAWOOD CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816207",
            "telephone_number": "864-501-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W BROAD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063210",
            "telephone_number": "864-596-2988",
            "fax_number": "864-336-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD SC,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "KEMBLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "864-501-0751",
        "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 City of Spartanburg Health Center-City Hall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.