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PROACTIVE MSO, LLC
NPI 1083250351
Clinic/Center - Primary Care in Plymouth, IN

Active since November 21, 2019
510 W ADAMS ST STE GL30, PLYMOUTH, IN 46563(812) 645-1892 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 24, 2025, Nov 21, 2019 (2 updates tracked since 2019).

About Proactive Mso, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROACTIVE MSO, LLC (NPI 1083250351), doing business as Proactive Md, is a healthcare organization registered as a primary care in Plymouth, Indiana and active in the NPI registry since November 2019. The organization lists Jody Addair, Clinical Ops Project Coordinator, as its authorized official.

NPPES Registry Identity

NPI1083250351
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MSO, LLC
Location Address510 W ADAMS ST STE GL30Plymouth, IN 46563-1784
Mailing Address124 Allawood CtSimpsonville, SC 29681-6207 · (864) 501-0751
Phone(812) 645-1892
Organization SubpartNo
Authorized OfficialJody AddairClinical Ops Project Coordinator · (317) 556-0017
Enumeration DateNovember 21, 2019
Last NPPES UpdateJune 24, 20252 updates tracked since enumeration
NPPES CertifiedJune 6, 2025
✔ NPI 1083250351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
510 W ADAMS ST STE GL30, Plymouth, IN 46563
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Other Names 2

Doing Business AsProactive Md
Doing Business AsProactive Md Plymouth Health Center

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARSHALL COUNTY INDIANA
Public Health or Welfare
510 W ADAMS ST STE GL30
PLYMOUTH, IN 46563
Marshall County (574) 935-8565

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 1083250351. It was assigned to this organization in the NPPES registry on November 21, 2019. The provider is doing business as Proactive MD and Proactive MD Plymouth Health Center.

Where is Proactive Mso, LLC located?

Proactive Mso, LLC is located at 510 W Adams St Ste Gl30, Plymouth, IN 46563. 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.

When was this NPI record last updated?

The NPPES record for Proactive Mso, LLC was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.