Proactive Health Services LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PROACTIVE HEALTH SERVICES LLC

Practice address

9712 Belair Rd Ste 301-301a
Nottingham, MD 21236-1103

Phone

(443) 902-6314

NPI assigned

Aug 5, 2024

Organization subpart

No

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

Authorized official

Name

Susan Saina Stubbs, NPNPI 1710472527

Title

NP

Phone

(443) 902-6314

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

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

• Susan Saina Stubbs, CRNP

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1710472527
  Medicare reassignment NPD Authorized official
• Caroline Njane

  • Primary Care Nurse Practitioner
  • Fremont, CA
  • NPI 1952845810

  Family, MD

  Medicare reassignment NPD

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1972333946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 BELAIR RD STE 301-301A",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361103",
            "telephone_number": "443-902-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9712 BELAIR RD STE 301-301A",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361103",
            "telephone_number": "443-902-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "STUBBS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "SAINA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "443-902-6314",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Asta Elizabeth Puskarich, CRNP-PMH

• Family Nurse Practitioner in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.