PROACTIVE MD
NPI 1972011815
Clinic/Center - Primary Care in Terre Haute, IN

Active since January 12, 2018CLIA Certified · 2 labs
3495 S 4TH ST, TERRE HAUTE, IN 47802(812) 220-4755 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Proactive Md NPPES

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

PROACTIVE MD (NPI 1972011815), doing business as Proactive Md Terre Haute Health Center, is a healthcare organization registered as a primary care in Terre Haute, Indiana and active in the NPI registry since January 2018. The organization holds 2 active CLIA laboratory certificates and lists Jan Hopkins, Assoc. Ops Mgr, as its authorized official.

NPPES Registry Identity

NPI1972011815
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROACTIVE MSO, LLC
Location Address3495 S 4TH STTerre Haute, IN 47802-5501
Mailing Address124 Allawood CtSimpsonville, SC 29681-6207 · (864) 501-0751
Organization SubpartNo
Authorized OfficialJan HopkinsAssoc. Ops Mgr · (864) 501-0751
Enumeration DateJanuary 12, 2018
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
NPI 1972011815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
3495 S 4TH ST, Terre Haute, IN 47802

Other Names 2

Other NameProactive Md
Doing Business AsProactive Md Terre Haute Health Center

CLIA Laboratory Certificates CMS CLIA 2

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 15D2144157

Proactive Md-Dpc Main · Terre Haute, IN
Active · expires Feb 11, 2028
CLIA Number15D2144157
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 12, 2026
Certificate Expiration DateFebruary 11, 2028
Laboratory DirectorMegan Marietta
Laboratory Phone(812) 220-4755
Laboratory LocationProactive Md-Dpc Main3495 S 4th St, Terre Haute, IN 47802
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2012999

Proactive MD Vcsc Health Center · Terre Haute, IN
Active · expires Sep 12, 2026
CLIA Number15D2012999
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 13, 2024
Certificate Expiration DateSeptember 12, 2026
Laboratory DirectorKenneth R. Massey
Laboratory Phone(812) 462-5799
Laboratory LocationProactive MD Vcsc Health Center3250 Maple Ave, Terre Haute, IN 47804
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Physician Assistant (Medical)
3495 S 4TH ST
TERRE HAUTE, IN 47802
Nurse Practitioner (Family)
3495 S 4TH ST
TERRE HAUTE, IN 47802

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 1972011815. It was assigned to this organization in the NPPES registry on January 12, 2018. The provider is doing business as Proactive MD Terre Haute Health Center. The provider is also known as Proactive MD.

Where is Proactive Mso, LLC located?

Proactive Mso, LLC is located at 3495 S 4th St, Terre Haute, IN 47802. The listed phone number is (812) 220-4755.

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 CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

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.