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Active NPI 1922777465 Organization (Entity Type 2)

Proactive Md Ia Pc

Clinic/Center - Primary Care • Sergeant Bluff, IA

Public Directory Information & Medical Disclaimer

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About Proactive Md Ia Pc NPI 1922777465 Summary

Proactive Md Ia Pc is a verified healthcare organization specializing in Clinic/Center - Primary Care operating in Sergeant Bluff, IA. Located at 1182 260TH ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1922777465.

Administrative operations and authorized compliance are overseen by Mark Kemble (Cmo).

Facility Location & Contact Primary Location

Facility Address

1182 260th St

Sergeant Bluff, IA 510547739

Telephone 7123171130

Authorized Official Information

Authorized Contact Name

Mark Kemble , MD

Title / Role

Cmo

Official Telephone

8646408355

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

7 Historical Events

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Updated Business Mailing Address June 29, 2026

Registered at 86 VILLA RD STE 100, GREENVILLE, SC 296153052 (Tel: 8645010751)

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NPI Profile Active September 08, 2021

NPI status registered as active in NPPES database

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Updated Practice Location September 08, 2021

Registered at 1182 260TH ST, SERGEANT BLUFF, IA 510547739 (Tel: 7123171130)

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Updated Business Mailing Address September 08, 2021

Registered at 10 CENTIMETERS DR, MAULDIN, SC 296623278 (Tel: 8645010751)

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Organization / Clinic Name Updated September 08, 2021

Operating as PROACTIVE MD IA PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2021

Clinic/Center

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Initial NPI Registration & Enumeration September 08, 2021

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1922777465

Entity Type:

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

Enumeration Date: September 08, 2021

Last Update: June 29, 2026

Update or Correct Listing

Mailing Address

86 Villa Rd Ste 100

Greenville, SC 296153052

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.