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Active NPI 1629614979 Organization (Entity Type 2)

Proactive Mso, Llc

Clinic/Center - Primary Care • Delphi, IN

About Proactive Mso, Llc NPI 1629614979 Summary

Proactive Mso, Llc is a verified healthcare organization specializing in Clinic/Center - Primary Care operating in Delphi, IN. Located at 300 W VINE ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1629614979.

Administrative operations and authorized compliance are overseen by Jan Hopkins (Assoc. Ops Mgr).

Facility Location & Contact Primary Location

Facility Address

300 W Vine St

Delphi, IN 469231651

Telephone 8126451892

Authorized Official Information

Authorized Contact Name

Jan Hopkins

Title / Role

Assoc. Ops Mgr

Official Telephone

8645010751

Facility Classifications & Specialties

Clinic/Center - Primary Care Primary Taxonomy

NUCC Taxonomy Code: 261QP2300X

Definition to come...

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

8 Historical Events

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Updated Business Mailing Address March 25, 2022

Registered at 124 ALLAWOOD CT, SIMPSONVILLE, SC 296816207 (Tel: 8645010751)

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Organization / Clinic Name Updated March 25, 2022

Operating as PROACTIVE MSO, LLC

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NPI Profile Active November 21, 2019

NPI status registered as active in NPPES database

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Updated Practice Location November 21, 2019

Registered at 300 W VINE ST, DELPHI, IN 469231651 (Tel: 8126451892)

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Updated Business Mailing Address November 21, 2019

Registered at 300 W VINE ST, DELPHI, IN 469231651

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Organization / Clinic Name Updated November 21, 2019

Operating as WELLNESS FOR LIFE

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2019

Clinic/Center

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Initial NPI Registration & Enumeration November 21, 2019

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1629614979

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: November 21, 2019

Last Update: March 25, 2022

Update or Correct Listing

Mailing Address

124 Allawood Ct

Simpsonville, SC 296816207

Phone: 8645010751

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.