PROACTIVE MD
NPI 1326577396
Clinic/Center - Primary Care in Vincennes, IN

Active since June 05, 2017CLIA 15D2129135 · Waiver
1602 UPPER 11TH ST, VINCENNES, IN 47591(812) 886-4557 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Proactive Md NPPES

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

PROACTIVE MD (NPI 1326577396), doing business as Proactive Md Vincennes Health Center, is a healthcare organization registered as a primary care in Vincennes, Indiana and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through April 12, 2027 and lists Jan Hopkins, Assoc. Ops. Mgr, as its authorized official.

NPPES Registry Identity

NPI1326577396
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MSO, LLC
Location Address1602 UPPER 11TH STVincennes, IN 47591-4820
Mailing Address124 Allawood CtSimpsonville, SC 29681-6207 · (864) 501-0751
Organization SubpartNo
Authorized OfficialJan HopkinsAssoc. Ops. Mgr · (864) 501-0751
Enumeration DateJune 5, 2017
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
NPI 1326577396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1602 UPPER 11TH ST, Vincennes, IN 47591

Other Names 2

Other NameProactive Md
Doing Business AsProactive Md Vincennes Health Center

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 15D2129135

Proactive Vincennes Health Center · Vincennes, IN
Active · expires Apr 12, 2027
CLIA Number15D2129135
Laboratory TypePractitioner Other
Certificate Effective DateApril 13, 2025
Certificate Expiration DateApril 12, 2027
Laboratory DirectorMichael Snell
Laboratory Phone(812) 886-4557
Laboratory LocationProactive Vincennes Health Center1602 N Upper 11th, Vincennes, IN 47591
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
1602 UPPER 11TH ST
VINCENNES, IN 47591

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 1326577396. It was assigned to this organization in the NPPES registry on June 5, 2017. The provider is doing business as Proactive MD Vincennes Health Center. The provider is also known as Proactive MD.

Where is Proactive Mso, LLC located?

Proactive Mso, LLC is located at 1602 Upper 11th St, Vincennes, IN 47591. The listed phone number is (812) 886-4557.

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 15D2129135) is associated with this NPI, valid through April 12, 2027. 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 March 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.