Proactive Mso, LLC
Clinic/Center, Primary Care in Terre Haute, IN. Organization (NPI-2).
NPI number1972011815
StatusActive
Last updated in NPPESSep 15, 2026
Details
- NPI
- 1972011815
- Entity type
- Organization (NPI-2)
- Legal business name
- Proactive Mso, LLC
- Organization subpart
- No
- Enumeration date
- Jan 12, 2018
- Certification date
- Sep 15, 2026
- Last updated
- Sep 15, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Other names
- Proactive MD (Other Name)
- Proactive MD Terre Haute Health Center (Doing Business As)
Practice location
3495 S 4th StTerre Haute, IN 47802-5501
Phone 812-220-4755
Mailing address
86 Villa Rd Ste 100Greenville, SC 29615-3052
Phone 864-640-8355
Authorized official
Mark A Kemble
Cmo
8646408355
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 5 Primary Care Clinic/Center providers in Terre Haute · All 2,936 providers in Terre Haute
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