PROACTIVE PAIN AND NEUROLOGY, LLC (NPI# 1669037008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669037008 |
| Entity Type | Organization |
| Organization Name | PROACTIVE PAIN AND NEUROLOGY, LLC |
| Other Organization Name | PROACTIVE PRIMARY CARE |
| Practice Address |
925 Bishop Walsh Rd Ste 10 Cumberland MD 21502-1845 |
| Mailing Address |
Po Box 1602 Cumberland MD 21501-1602 |
| Practice Telephone | 2403627025 |
| Practice Fax Number | 2403627064 |
| Mailing Telephone | 2403627025 |
| Mailing Fax Number | 2403627064 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | PAMELA DENISE BUCKEL (OFFICE MANAGER) |
| Authorized Official Telephone | 2403627025 |
| Is Organization Subpart | Y |
| Parent Organization Name | 1417460619 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 278902700 | 05 | |
| MD | CAREFIRST | DL77 | 01 |
| MD | MEDICARE | 622188 | 01 |
| MD | 999023200 | 05 |
| Other Name | Type Code |
|---|---|
| Proactive Primary Care | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 921 Seton Dr Ste Fandg, Cumberland, MD 215021852 | 2405220098 | 2405220099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417460619 | Proactive Pain and Neurology, LLC | Neurological Surgery | 921 Seton Dr Ste F&g, Cumberland, MD 21502-1852 | 2017-11-09 |
| Street Address |
925 BISHOP WALSH RD STE 10 |
| City | CUMBERLAND |
| State | MD |
| Zip Code | 21502-1845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141592 | Upmc Western Maryland Corporation | Clinic/Center | 10700 Leslie Lane, Cumberland, MD 21502 | 2020-07-13 |
| 1669934212 | Ultimate Hearing Solutions Vi, LLC | Durable Medical Equipment & Medical Supplies | 701 Park Street, Queen City Centre, Cumberland, MD 21502 | 2019-04-03 |
| 1114497070 | Dianne Liller | Speech-Language Pathologist | 200 Massachusetts Ave, Cumberland, MD 21502 | 2018-12-04 |
| 1386111409 | Rebecca Anne Stewart | Counselor | 217 Glenn Street, Suite 401, Cumberland, MD 21502 | 2018-10-26 |
| 1396222998 | Crystal Lynne Walls | Nurse Practitioner | Western Maryland Health System, 12500 Willowbrook Rd, Cumberland, MD 21502 | 2018-07-26 |
| 1841796554 | Joan Kathleen Hoban | Speech-Language Pathologist | Potomac Behavioral and Occupational Therapy, 240 Henderson Ave., Cumberland, MD 21502 | 2018-04-02 |
| 1760984447 | Christine T. Haines | Social Worker | 907 Seton Drive, Cumberland, MD 21502 | 2018-03-08 |
| 1033632328 | Nicole Mabury | Counselor | 12501 Willowbrook Road, Cumberland, MD 21502 | 2017-07-19 |
| 1073042479 | The Lions Center for Rehabilitation and Extended Care, Inc. | Skilled Nursing Facility | 901 Seton Drive, Cumberland, MD 21502 | 2017-06-08 |
| 1912446816 | Marina Hurst | Counselor | 10102 County Club Road Se, Cumberland, MD 21502 | 2017-02-13 |
| Find all providers in zip 21502 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001818 | Shannon Nicole Martin | Nurse Practitioner | 924 Seton Dr # C, Cumberland, MD 21502-1851 | 2020-10-21 |
| 1518586478 | Justin Newsome | Nurse Practitioner | 209 Field St, Cumberland, KY 40823-1407 | 2020-04-10 |
| 1043782790 | Prestige Family Healthcare LLC | Nurse Practitioner | 15 S Centre St, Cumberland, MD 21502-3017 | 2018-12-19 |
| 1396222998 | Crystal Lynne Walls | Nurse Practitioner | Western Maryland Health System, 12500 Willowbrook Rd, Cumberland, MD 21502 | 2018-07-26 |
| 1528556503 | Leigh Ann Wiltison | Nurse Practitioner | 15113 Trail Ridge Rd Sw # 11513, Cumberland, MD 21502-5846 | 2018-04-25 |
| 1972943322 | Belinda Hester | Nurse Practitioner | 72 Greene St, Cumberland, MD 21502-2933 | 2013-06-30 |
| 1750680831 | Krista Dawn Self | Nurse Practitioner | 14100 Mcmullen Hwy Sw, Cumberland, MD 21502-5777 | 2011-03-15 |
| 1548410921 | Cheryl K Nelson | Nurse Practitioner | 12401 Willowbrook Rd, Cumberland, MD 21502-2559 | 2008-09-23 |
| 1407973894 | Michele Wagoner | Nurse Practitioner | 1050 W Industrial Blvd Ste 17, Cumberland, MD 21502-4331 | 2007-03-23 |
| 1750334728 | Robin Ann Hart | Nurse Practitioner | 2138 Mendon Rd Ste 101b, Cumberland, RI 02864-3832 | 2006-05-18 |
| Find all providers in CUMBERLAND | ||||
| City | CUMBERLAND |
| Zip Code | 21502 |
Please comment or provide details below to improve the information on PROACTIVE PAIN AND NEUROLOGY, LLC.
| 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.