PROACTIVE MSO, LLC
NPI 1073066866
Clinic/Center - Primary Care in Merrillville, IN
About Proactive Mso, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROACTIVE MSO, LLC (NPI 1073066866), doing business as Proactive Md, is a healthcare organization registered as a primary care in Merrillville, Indiana and active in the NPI registry since July 2016. The organization holds a CLIA Waiver certificate valid through October 10, 2026 and lists Mark A Kemble, Chief Medical Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 42D2312454
Proactive MD Percival Health Center · Columbia, SCOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Proactive Mso, LLC's NPI number?
The NPI number for Proactive Mso, LLC is 1073066866. It was assigned to this organization in the NPPES registry on July 27, 2016. The provider is doing business as Proactive MD and Proactive MD Merrillville Health Center.
Where is Proactive Mso, LLC located?
Proactive Mso, LLC is located at 387 E 84th Dr, Merrillville, IN 46410. The listed phone number is (812) 645-1892.
What is Proactive Mso, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Proactive Mso, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2312454) is associated with this NPI, valid through October 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Proactive Mso, LLC was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Proactive Mso, Llc · NPI 1073066866
Primary Care organization in Merrillville, Indiana. Organization record, active in the CMS NPPES registry since July 27, 2016.
## Identity
- **NPI:** 1073066866 (Entity type: Organization)
- **Enumerated:** July 27, 2016
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** Proactive MD (Doing Business As); Proactive MD Merrillville Health Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Mark Kemble, CHIEF MEDICAL OFFICER
## Practice location
- **Address:** 387 E 84TH DR, Merrillville, IN 46410-6484
- **Phone:** (812) 645-1892
## Record status
- **NPPES last updated:** September 8, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073066866) · Data from the CMS NPPES public registry.