PROACTIVE MD WI SC – NPI #1134753411
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

PROACTIVE MD WI SC is a provider located in WESTFIELD, WI. NPPES has assigned the NPI number 1134753411 to PROACTIVE MD WI SC on February 26, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. PROACTIVE MD WI SC is also known by the name PROACTIVE MD. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 4 years ago on Apr 01, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROACTIVE MD WI SC below.

NPI Profile for
PROACTIVE MD WI SC

NPI Number
1134753411
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROACTIVE MD WI SC
Other Name: PROACTIVE MD
Other name(s)
All associated names:
Other Name
PROACTIVE MD
Doing Business As (dba)
Proactive MD Brakebush Westfield Health Center
Primary location
BRAKEBUSH HEALTH CENTER
N4993 6TH DR.
WESTFIELD, WI 53964
Phone: (800) 933-2121 Fax:
Mailing address
124 ALLAWOOD CT
SIMPSONVILLE, SC 29681-6207
Phone: (864) 501-0751 Fax:
Organization Subpart
No
Authorized Official
JAN HOPKINS
ASSOC. OPS MGR
Phone: (864) 501-0751
Updated
Certification Date
Apr 01, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.