Proactive MD TX Professional Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROACTIVE MD TX PROFESSIONAL CORPORATION

Practice address

86 Villa Rd Ste 100
Greenville, SC 29615-3052

Phone

(864) 501-0751

NPI assigned

Aug 9, 2023

Organization subpart

No

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

Authorized official

Name

Mark Kemble, MD

Title

Cmo

Phone

(864) 640-8355

Specialties & licenses 1

Addresses

Other names 1

• Proactive MD Doing business as

Tax ID family

PMD Brakebush Health Center-Irving3 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 TX Professional Corporation

  • Primary Care Clinic/Center
  • San Antonio, TX
  • NPI 1245013192
  NPD tax ID
• Proactive MD TX Professional Corporation

  • Primary Care Clinic/Center
  • Irving, TX
  • NPI 1649853771
  NPD tax ID

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1861175697",
    "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": "86 VILLA RD STE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153052",
            "telephone_number": "864-501-0751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Allawood Ct",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296816207",
            "country_code": "US",
            "telephone_number": "864-501-0751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROACTIVE MD TX PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "KEMBLE",
        "authorized_official_first_name": "MARK",
        "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",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Proactive MD Ok LLC
• Proactive MD Penn PC
• Proactive MD SC,P.a.
• Proactive MD SC,P.a.
• Proactive MD TN PC
• Proactive MD Wi SC
• Proactive Mso, LLC
• Letty Probasco, MD
• Ronne Justine Proch, DO
• Kate Prochaska

• Primary Care Clinic/Center in Greenville, SC
• Providers in Greenville, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.