PROACTIVE MD
NPI 1427569367
Clinic/Center - Primary Care in Bloomington, IN

Active since October 18, 2017CLIA 15D2138522 · Waiver
524 N FAIRVIEW ST, BLOOMINGTON, IN 47404(812) 645-1892 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 1427569367), doing business as Proactive Md Monroe Health Center, is a healthcare organization registered as a primary care in Bloomington, Indiana and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through October 18, 2027 and lists Jan Hopkins, Assoc. Ops Mgr, as its authorized official.

NPPES Registry Identity

NPI1427569367
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MSO, LLC
Location Address524 N FAIRVIEW STBloomington, IN 47404-3774
Mailing Address124 Allawood CtSimpsonville, SC 29681-6207 · (864) 501-0751
Organization SubpartNo
Authorized OfficialJan HopkinsAssoc. Ops Mgr · (864) 501-0751
Enumeration DateOctober 18, 2017
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
NPI 1427569367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
524 N FAIRVIEW ST, Bloomington, IN 47404

Other Names 2

Other NameProactive Md
Doing Business AsProactive Md Monroe 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 15D2138522

Proactive MD Monroe Health Center · Bloomington, IN
Active · expires Oct 18, 2027
CLIA Number15D2138522
Laboratory TypePractitioner Other
Certificate Effective DateOctober 19, 2025
Certificate Expiration DateOctober 18, 2027
Laboratory DirectorCasey Hood
Laboratory Phone(812) 330-7837
Laboratory LocationProactive MD Monroe Health Center524 N Fairview St, Bloomington, IN 47404
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Nurse Practitioner (Family)
524 N FAIRVIEW ST
BLOOMINGTON, IN 47404
Family Medicine
524 N FAIRVIEW ST
BLOOMINGTON, IN 47404
Nurse Practitioner (Family)
524 N FAIRVIEW ST
BLOOMINGTON, IN 47404
Family Medicine
524 N FAIRVIEW ST
BLOOMINGTON, IN 47404

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 1427569367. It was assigned to this organization in the NPPES registry on October 18, 2017. The provider is doing business as Proactive MD Monroe Health Center. The provider is also known as Proactive MD.

Where is Proactive Mso, LLC located?

Proactive Mso, LLC is located at 524 N Fairview St, Bloomington, IN 47404. 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 15D2138522) is associated with this NPI, valid through October 18, 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.