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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PROACTIVE MSO, LLC
NPI 1790223048
Clinic/Center - Primary Care in Lafayette, IN

Active since February 07, 2017
2400 SAGAMORE PKWY S, LAFAYETTE, IN 47905(765) 772-4086 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 2, 2026, Feb 7, 2017 (2 updates tracked since 2017).

About Proactive Mso, Llc NPPES

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

PROACTIVE MSO, LLC (NPI 1790223048), doing business as Proactive Md Dana Lafayette Health Center, is a healthcare organization registered as a primary care in Lafayette, Indiana and active in the NPI registry since February 2017. The organization lists Mark A Kemble, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1790223048
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MSO, LLC
Location Address2400 SAGAMORE PKWY SLafayette, IN 47905-5116
Mailing Address86 Villa Rd Ste 100Greenville, SC 29615-3052 · (864) 640-8355
Phone(765) 772-4086
Organization SubpartNo
Authorized OfficialMark A KembleChief Medical Officer · (864) 640-8355
Enumeration DateFebruary 7, 2017
Last NPPES UpdateSeptember 2, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2026
✔ NPI 1790223048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
2400 SAGAMORE PKWY S, Lafayette, IN 47905
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Other Names 2

Doing Business AsProactive Md Dana Lafayette Health Center
Other NameProactive Md

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.

HILLARY LOCKER FNP
Nurse Practitioner (Family)
2400 SAGAMORE PKWY S
LAFAYETTE, IN 47905
Tippecanoe County (765) 772-4086
MS. JESSICA F PURCELL FNP-BC
Nurse Practitioner (Family)
2400 SAGAMORE PKWY S
LAFAYETTE, IN 47905
Tippecanoe County (765) 772-4086
TERESA LYNN LEWIS FNP
Nurse Practitioner
2400 SAGAMORE PKWY S
LAFAYETTE, IN 47905
Tippecanoe County (765) 772-4086
DAWN A LORTON NP
Nurse Practitioner (Family)
2400 SAGAMORE PKWY S
LAFAYETTE, IN 47905
Tippecanoe County (765) 772-4086

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 1790223048. It was assigned to this organization in the NPPES registry on February 7, 2017. The provider is doing business as Proactive MD Dana Lafayette Health Center. The provider is also known as Proactive MD.

Where is Proactive Mso, LLC located?

Proactive Mso, LLC is located at 2400 Sagamore Pkwy S, Lafayette, IN 47905. The listed phone number is (765) 772-4086.

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 September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.