Proactive MD Ia PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROACTIVE MD IA PC

Doing business as

Proactive MD CF Port Neal Health Center

Practice address

1182 260TH St
Sergeant Bluff, IA 51054-7739

Phone

(712) 317-1130

Fax

(833) 307-1861

NPI assigned

Sep 8, 2021

Last updated

Aug 25, 2026By the provider in NPPES

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 1

• Proactive MD CF Port Neal Health Center Doing business as

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

Proactive MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Proactive MD Ia PC

  dba Proactive MD

  • Primary Care Clinic/Center
  • Greenville, SC
  • NPI 1558032011
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Kaye Anderson, APRN

  • Family Nurse Practitioner
  • Norfolk, NE
  • NPI 1811414303
  NPD

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1922777465",
    "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": "1182 260TH ST",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510547739",
            "telephone_number": "712-317-1130",
            "fax_number": "833-307-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MD IA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proactive MD CF Port Neal Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive MD CF Port Neal Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nissen Family Chiropractic PC
• Lyle D Nissen, D.C.
• Grant Michael Nobles, D.C.
• Oluwatoyin Adebanke Oyerinde, RN
• Play by Play Pediatric Therapy
• Richard K Bokemper DDS PC
• Beverly Schuster
• Sergeant Bluff Dental, PC (Sergeant Bluff Dental)
• Sergeant Bluff Dental, PLLC
• Sergeant Bluff Pharmacy Inc (Sergeant Bluff Pharmacy)

• Primary Care Clinic/Center in Sergeant Bluff, IA
• Providers in Sergeant Bluff, IA by specialty
• Primary Care Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.