PROACTIVE MD
NPI 1508319393
Clinic/Center - Primary Care in Montezuma, IN
About Proactive Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROACTIVE MD (NPI 1508319393), doing business as Proactive Md Montezuma Health Center, is a healthcare organization registered as a primary care in Montezuma, Indiana and active in the NPI registry since July 2016. The organization holds a CLIA Waiver certificate valid through September 11, 2027 and lists Jan Hopkins, Assoc. Ops Mgr, 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 15D2065622
Proactive MD Montezuma Health Center · Montezuma, INFrequently 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 1508319393. It was assigned to this organization in the NPPES registry on July 27, 2016. The provider is doing business as Proactive MD Montezuma Health Center. The provider is also known as Proactive MD.
Where is Proactive Mso, LLC located?
Proactive Mso, LLC is located at 617 E Strawberry Rd, Montezuma, IN 47862. The listed phone number is (765) 280-0550.
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 15D2065622) is associated with this NPI, valid through September 11, 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.
# Proactive Md · NPI 1508319393
Primary Care organization in Montezuma, Indiana. Organization record, active in the CMS NPPES registry since July 27, 2016.
## Identity
- **NPI:** 1508319393 (Entity type: Organization)
- **Enumerated:** July 27, 2016
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Proactive Mso, Llc
- **Also known as:** Proactive MD Montezuma Health Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Jan Hopkins, ASSOC. OPS MGR
## Practice location
- **Address:** 617 E STRAWBERRY RD, Montezuma, IN 47862-8116
- **Phone:** (765) 280-0550
## Record status
- **NPPES last updated:** March 25, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508319393) · Data from the CMS NPPES public registry.