PROACTIVE MD TN PC NPI 1073375242

NPI Information

  • NPI: 1073375242
  • Provider Name: PROACTIVE MD TN PC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: THRIVE HEALTH AND WELLNESS CENTER
  • Address: 100 N MAIN ST RM 105
    CLINTON, TN
    ZIP 37716
  • Phone: (865) 350-5225

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NPI Details

PROACTIVE MD TN PC is a primary care clinic center in Clinton, TN. PROACTIVE MD TN PC NPI is 1073375242. The provider is registered as an organization entity type.
The provider Is Doing Business As Thrive Health And Wellness Center.

The provider's business location address is:

100 N MAIN ST RM 105
CLINTON, TN
ZIP 37716-623
Phone: (865) 350-5225

The provider's authorized official is Jody Addair .
The authorized official title is Clinical Ops Project Coordinator and has the following contact phone number (317) 556-0017.

The enumeration date for this NPI number is 1/24/2024 and was last updated on 11/22/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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