Active NPI
Proactive Associates, LLC
- Home Health Agency
- Wichita, KS
National Provider Identifier
1902009079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- A087065
- Legal business name
- PROACTIVE ASSOCIATES, LLC
- Practice address
- 3450 N Rock Road
213
Wichita, KS 67226-1352 - Phone
- (316) 688-5511
- Fax
- (316) 688-1081
- NPI assigned
- Jun 7, 2007
- Organization subpart
- Yes
- Parent organization
- PHOENIX HOME CARE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- George Scott Herman
- Title
- President & Secretary
- Phone
- (512) 632-7156
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | A087065 | KS | Primary |
Addresses
Primary practice location
3450 N Rock Road
213
Wichita, KS 67226-1352
Mailing address
2450 N Rock Road
Suite # 213, Attn: Debra Mullen
Wichita, KS 67060
Phone (316) 688-5511
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100289090A | Medicaid | KS | |
| 100242630E | Medicaid | KS | |
| 100289090B | Medicaid | KS |
Other names 1
- Phoenix Home Care
National Provider Directory
National Provider Directory- Part of
- Phoenix Home Care LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638921600000",
"number": "1902009079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 N ROCK ROAD",
"address_2": "SUITE # 213, ATTN: DEBRA MULLEN",
"city": "WICHITA",
"state": "KS",
"postal_code": "67060",
"telephone_number": "316-688-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 N ROCK ROAD",
"address_2": "213",
"city": "WICHITA",
"state": "KS",
"postal_code": "672261352",
"telephone_number": "316-688-5511",
"fax_number": "316-688-1081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROACTIVE ASSOCIATES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PHOENIX HOME CARE, INC.",
"enumeration_date": "2007-06-07",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A",
"authorized_official_last_name": "HERMAN",
"authorized_official_first_name": "GEORGE",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT & SECRETARY",
"authorized_official_telephone_number": "512-632-7156"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "KS",
"license": "A087065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100289090A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100242630E",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100289090B",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Phoenix Home Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Phoenix Home Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.