PROACTIVE MD WI SC
NPI 1932935962
Clinic/Center - Primary Care in Waukesha, WI

Active since September 09, 2024
20611 WATERTOWN RD STE C, WAUKESHA, WI 53186(864) 501-0751 Get Directions Write a Review

NPPES record last updated: September 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Proactive Md Wi Sc NPPES

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

PROACTIVE MD WI SC (NPI 1932935962), doing business as Proactive Md Family Health Center, is a healthcare organization registered as a primary care in Waukesha, Wisconsin and active in the NPI registry since September 2024. The organization lists Jody Addair, Clinical Ops Project Coordinator, as its authorized official.

NPPES Registry Identity

NPI1932935962
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MD WI SC
Location Address20611 WATERTOWN RD STE CWaukesha, WI 53186-1871
Mailing Address124 Allawood CtSimpsonville, SC 29681-6207 · (864) 501-0751
Organization SubpartNo
Authorized OfficialJody AddairClinical Ops Project Coordinator · (317) 556-0017
Enumeration DateSeptember 9, 2024
NPPES CertifiedSeptember 8, 2024
NPI 1932935962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
20611 WATERTOWN RD STE C, Waukesha, WI 53186

Other Names 1

Doing Business AsProactive Md Family Health Center

Other Providers at the Same Location NPPES

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

Preventive Medicine (Occupational Medicine)
20611 WATERTOWN RD STE C
WAUKESHA, WI 53186

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 MD Wi Sc's NPI number?

The NPI number for Proactive MD Wi Sc is 1932935962. It was assigned to this organization in the NPPES registry on September 9, 2024. The provider is doing business as Proactive MD Family Health Center.

Where is Proactive MD Wi Sc located?

Proactive MD Wi Sc is located at 20611 Watertown Rd Ste C, Waukesha, WI 53186. The listed phone number is (864) 501-0751.

What is Proactive MD Wi Sc'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 MD Wi Sc was last updated on September 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.