PROACTIVE MD SC,P.A. (NPI# 1134753411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134753411 |
| Entity Type | Organization |
| Organization Name | PROACTIVE MD SC,P.A. |
| Practice Address |
Brakebush Health Center N4993 6th Dr. Westfield WI 53964 |
| Mailing Address |
10 Centimeters Dr Mauldin SC 29662-3278 |
| Practice Telephone | 8009332121 |
| Mailing Telephone | 8649078412 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | MARK ALLEN KEMBLE (EVP MEDICAL AFFAIRS) |
| Authorized Official Telephone | 8645010751 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PROACTIVE MD SC,P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538713813 | Proactive Md Sc,p.a. | Family Medicine | 101 W Saint John St Ste 107, Spartanburg, SC 29306-5157 | 2019-07-25 |
| 1073171336 | Proactive Md Sc,p.a. | Family Medicine | 801 Union St, Spartanburg, SC 29302-2734 | 2019-06-03 |
| 1932764321 | Proactive Md Sc,p.a. | Family Medicine | 2556 Wagener Rd, Aiken, SC 29801-9572 | 2019-05-01 |
| 1659816932 | Proactive Md Sc,p.a. | Clinic/Center | 223 Adley Way, Greenville, SC 29607-6511 | 2016-12-22 |
| 1639722101 | Proactive Md Sc,p.a. | Family Medicine | 9098 Fairforest Rd, Spartanburg, SC 29301-1134 | 2019-07-23 |
| 1619535978 | Proactive Md Sc,p.a. | Family Medicine | 145 W Broad St, Spartanburg, SC 29306-3210 | 2019-06-03 |
| 1750843132 | Proactive Md Sc,p.a. | Family Medicine | 245 Parkway E, Duncan, SC 29334-9489 | 2019-04-03 |
| Street Address |
BRAKEBUSH HEALTH CENTER N4993 6TH DR. |
| City | WESTFIELD |
| State | WI |
| Zip Code | 53964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184007650 | Elizabeth Gust | Physical Therapist | 211 N Pioneer Park Rd, Westfield, WI 53964 | 2015-07-02 |
| 1215075296 | Northland Community Services Inc | Clinic/Center | 161 Spring St, Westfield, WI 53964 | 2007-02-02 |
| 1437203023 | Annette Faith Gouker | Chiropractor | 128 East 2nd Street, Westfield, WI 53964 | 2007-01-22 |
| 1053465708 | Terry Ann Pace | Chiropractor | 128 East 2nd Street, Westfield, WI 53964-0095 | 2007-01-22 |
| 1245378660 | Pace Chiropractic Office Sc | Chiropractor | 128 East 2nd Street, Westfield, WI 53964-0095 | 2007-02-01 |
| 1295843951 | Robert E Crawford | Dentist | 120 E 2nd Street, Westfield, WI 53964-0220 | 2006-08-25 |
| 1902970205 | Bentley Pharmacies Inc | Pharmacy | 206 S Main St, Westfield, WI 53964-7506 | 2006-11-20 |
| 1376737783 | Westfield School District | Local Education Agency (LEA) | N7046 Cty Rd Ch, Westfield, WI 53964-8066 | 2007-08-29 |
| 1073067013 | Interra Health Inc. | Clinic/Center | N4993 6th Dr, Westfield, WI 53964-8200 | 2016-08-08 |
| 1871127092 | Proactive Md - Brakebush | Clinic/Center | N4993 6th Dr, Westfield, WI 53964-8200 | 2020-02-26 |
| Find all providers in zip 53964 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134568991 | Jeffrey D. Klak | Family Medicine | 510 E State Road 32, Suite A, Westfield, IN 46074-8767 | 2013-06-14 |
| 1619136017 | Kara Jihea Choi | Family Medicine | 57 Union St Ste 201, Westfield, MA 01085-4224 | 2008-06-02 |
| 1073699294 | Robert A Hevert | Family Medicine | 1240 Summit Ave, Westfield, NJ 07090 | 2006-10-31 |
| 1629174669 | Nicole Henry-dindial | Family Medicine | 563 Springfield Ave, Westfield, NJ 07090-1002 | 2006-09-16 |
| 1629003678 | Jennifer M Mardos | Family Medicine | 380 S Junction Xing, Suite 100, Westfield, IN 46074-7852 | 2006-07-11 |
| 1912934019 | Susan J Miller | Family Medicine | 222 Church St, Westfield, PA 16950-1538 | 2006-06-26 |
| 1467488668 | American Health Network of Indiana, LLC | Family Medicine | 15229 Us 31 N, Westfield, IN 46074 | 2006-06-23 |
| 1568431302 | Valerie A Beard | Family Medicine | 17600 Shamrock Blvd Ste 500b, Westfield, IN 46074-7002 | 2006-03-15 |
| 1912993866 | Lee Hoyt Miller | Family Medicine | 1081 Liberty Dr, Westfield, IN 46074-8054 | 2005-09-26 |
| 1083608418 | Matthew D Wehr | Family Medicine | 138 E Main St, Westfield, NY 14787-1121 | 2005-08-31 |
| Find all providers in WESTFIELD | ||||
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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.