Organization · Type 2 NPI

Proactive MD MS LLC

Primary Care Clinic/Center · Ecru, MS

NPI number 1740042563 Active

Practice location

6543 MS-15
Ecru, MS 38841

Call (662) 489-2669 Map

Mailing address

86 Villa Rd Ste 100
Greenville, SC 29615-3052

Specialties and licenses

Taxonomy	Code	License
Primary Care Clinic/Center Primary	261QP2300X	None listed

Primary Care Clinic/Center: Definition to come...

NPI record

NPI: 1740042563
Entity type: Organization (Type 2)
Issued: Jan 26, 2024
Last updated: Aug 25, 2026
Status: Active

Other names

<unavail>
Ashley Wellness Center · doing business as
Ashley Wellness Center · doing business as

Authorized official

Mark Allen Kemble, MD
Chief Medical Officer
(864) 640-8355

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1740042563

Proactive MD MS LLC's National Provider Identifier is 1740042563, issued on Jan 26, 2024. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Ecru, MS. The record was last updated on Aug 25, 2026.