Proactive Healthcare

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

41988 Issued in MN

Legal business name

PROACTIVE HEALTHCARE

Practice address

101 5TH St E
Suite 227
Saint Paul, MN 55101-1898

Phone

(651) 778-0080

Fax

(651) 778-0195

NPI assigned

Jun 19, 2012

Organization subpart

No

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

Authorized official

Name

Nathan BurdashNPI 1861553588

Title

C.E.O.

Phone

(651) 778-0080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

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

• Nathan Burdash, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1861553588
  Medicare reassignment NPD Authorized official
• Nuzhat S Majid, MD

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1073578225
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1891058384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 5TH ST E",
            "address_2": "SUITE 227",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011898",
            "telephone_number": "651-778-0080",
            "fax_number": "651-778-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 5TH ST E",
            "address_2": "SUITE 227",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011898",
            "telephone_number": "651-778-0080",
            "fax_number": "651-778-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "BURDASH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "651-778-0080"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MN",
            "license": "41988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891058384",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony R Prisco, M.D., PH.D.
• Pristine Mental Health Services LLC
• Kimberly R Pritchett, OTR/L
• Sarah Ann Privette, AU.D.
• Pro Nutrition Solutions
• Janice Marie Probst, RN
• Proeyecare Associates PA
• Professional Resource Network, Inc
• Professional Resource Network, Inc
• Professional Translators & Interpreters

• General Practice Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.