PROACTIVE WELLNESS NP
NPI 1124704085
Clinic/Center - Multi-Specialty in Columbia, MD

Q: What is Proactive Wellnessnp's NPI number?

The NPI number for Proactive Wellnessnp is 1124704085. It was assigned to this organization in the NPPES registry on June 26, 2023. The provider is doing business as Proactive Wellness Np.

Q: What is Proactive Wellnessnp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since June 26, 2023

12114 BLUE FLAG WAY, COLUMBIA, MD 21044(301) 741-0307 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 6, 2023, Nov 6, 2023 (2 updates tracked since 2023).

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About Proactive Wellness Np NPPES

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

PROACTIVE WELLNESS NP (NPI 1124704085) is a healthcare organization registered as a multi-specialty in Columbia, Maryland and active in the NPI registry since June 2023. The organization lists Kondi Walterssmith, Ceo/ Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1124704085

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NamePROACTIVE WELLNESSNP

Location Address12114 BLUE FLAG WAYColumbia, MD 21044

Mailing Address12114 Blue Flag WayColumbia, MD 21044 · (301) 741-0307

Phone(301) 741-0307

Organization SubpartNo

Authorized OfficialKondi WalterssmithCeo/ Nurse Practitioner · (301) 741-0307

Enumeration DateJune 26, 2023

Last NPPES UpdateDecember 6, 20232 updates tracked since enumeration

NPPES CertifiedDecember 6, 2023

✔ NPI 1124704085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

Also ListedClinic/Center · Recovery CareTaxonomy 261QR0800X

12114 BLUE FLAG WAY, Columbia, MD 21044

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Other Names 1

Doing Business AsProactive Wellness Np

Other Providers at the Same Location NPPES

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

MRS. KONDI O WALTERS-SMITH CRNP

Nurse Practitioner (Family)

12114 BLUE FLAG WAY
COLUMBIA, MD 21044

Howard County (301) 741-0307

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 Wellnessnp's NPI number?

The NPI number for Proactive Wellnessnp is 1124704085. It was assigned to this organization in the NPPES registry on June 26, 2023. The provider is doing business as Proactive Wellness Np.

Where is Proactive Wellnessnp located?

Proactive Wellnessnp is located at 12114 Blue Flag Way, Columbia, MD 21044. The listed phone number is (301) 741-0307.

What is Proactive Wellnessnp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Proactive Wellnessnp was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.