PROACTIVE MEDICAL CENTER (NPI# 1053946004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053946004 |
| Entity Type | Organization |
| Organization Name | PROACTIVE MEDICAL CENTER |
| Practice Address |
3455 Peachtree Industrial Blvd Ste 910 Duluth GA 30096-6502 |
| Practice Telephone | 6785845000 |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | ANDREW HYUN (EMPLOYEE) |
| Authorized Official Telephone | 7703673325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
3455 PEACHTREE INDUSTRIAL BLVD STE 910 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-6502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1548613987 | Sequence To Health | General Practice | 3790 Pleasant Hill Road, Suite 260, Duluth, GA 30096-5147 | 2016-07-21 |
| 1437423266 | Horst G May | General Practice | 2314 Greysolon Rd, Duluth, MN 55812-2206 | 2012-02-24 |
| 1619063039 | Andrew John Vasil | General Practice | 623 Pacific Ave, Duluth, MN 55806-1336 | 2006-10-04 |
| 1023421914 | Dana Health and Wellness Center Inc | General Practice | 2472 Pleasant Hill Rd, Suite 203a, Duluth, GA 30096-1746 | 2014-06-09 |
| 1750589966 | Malcolm L. Mccutcheon | General Practice | 714 W College St, Duluth, MN 55811-4906 | 2007-07-10 |
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| 1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.