PROACTIVE MD OH LLC NPI 1316710742

NPI Information

  • NPI: 1316710742
  • Provider Name: PROACTIVE MD OH LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: PROACTIVE MD
  • Address: 124 ALLAWOOD CT
    SIMPSONVILLE, SC
    ZIP 29681
  • Phone: (864) 501-0751

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NPI Details

PROACTIVE MD OH LLC is a primary care clinic center in Simpsonville, SC. PROACTIVE MD OH LLC NPI is 1316710742. The provider is registered as an organization entity type.
The provider Is Doing Business As Proactive Md.

The provider's business location address is:

124 ALLAWOOD CT
SIMPSONVILLE, SC
ZIP 29681-207
Phone: (864) 501-0751

The provider's authorized official is Jody Addair .
The authorized official title is Clinical Ops Project Coord. and has the following contact phone number (864) 501-0751.

The enumeration date for this NPI number is 11/7/2023 and was last updated on 9/26/2024.

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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