NPIMap

Organization Active NPI

Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Morocco, IN
National Provider Identifier
1669129201
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROACTIVE MSO, LLC
Practice address
4117 S 240 W Ste 200
Morocco, IN 47963-8194
Phone
(864) 501-0751
NPI assigned
Mar 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Jan Hopkins
Title
Assoc. Ops Manager
Phone
(864) 501-0751

Specialties & licenses 1

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

Addresses

Primary practice location

4117 S 240 W Ste 200
Morocco, IN 47963-8194

Mailing address

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

Other names 1

  • Newton County Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
W Lafayette Health Center35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1669129201",
    "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": "4117 S 240 W STE 200",
            "city": "MOROCCO",
            "state": "IN",
            "postal_code": "479638194",
            "telephone_number": "864-501-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MSO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "ASSOC. OPS MANAGER",
        "authorized_official_telephone_number": "864-501-0751"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newton County Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morocco, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.