Proactive Mso, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROACTIVE MSO, LLC

Doing business as

Proactive MD Valpo Health Center

Practice address

2801 Bertholet Blvd Ste 201
Valparaiso, IN 46383-7959

Phone

(844) 458-2800

NPI assigned

Jul 27, 2016

Organization subpart

No

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

Authorized official

Name

Mark A Kemble, MD

Title

Cmo

Phone

(864) 640-8355

Specialties & licenses 1

Addresses

Other names 2

• Proactive MD Valpo Health Center Doing business as
• Proactive MD Other name

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

CLIA laboratory certificates

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.

• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Spencer, IN
  • NPI 1033662820
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Winamac, IN
  • NPI 1063058311
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Veedersburg, IN
  • NPI 1073066056
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Merrillville, IN
  • NPI 1073066866
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Plymouth, IN
  • NPI 1083250351
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Brazil, IN
  • NPI 1174076145
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Crawfordsville, IN
  • NPI 1174169908
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • New Carlisle, IN
  • NPI 1275179541
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Bloomington, IN
  • NPI 1275371080
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Union Mills, IN
  • NPI 1285359679
  NPD tax ID
• Proactive Mso, LLC

  • Clinic/Center
  • Martinsville, IN
  • NPI 1316811433
  NPD tax ID
• Proactive Mso, LLC

  • Primary Care Clinic/Center
  • Vincennes, IN
  • NPI 1326577396
  NPD tax ID

Locations

Practitioners 1

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

• Blake Hansen, DNP, FNP-C

  • Family Nurse Practitioner
  • Valparaiso, IN
  • NPI 1962195016
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1689127474",
    "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": "2801 BERTHOLET BLVD STE 201",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837959",
            "telephone_number": "844-458-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MSO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "KEMBLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CMO",
        "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 Valpo Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Vanessa Jean Provins, RD
• Penny Pryor, RPH
• Cloe Psomadelis, LMHC

• Primary Care Clinic/Center in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.