Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Proactive MD Wi SC

Organization Primary Care Clinic/Center · NPI 1932935962

Proactive MD Wi SC is a Primary Care Clinic/Center in Waukesha, Wisconsin. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

20611 Watertown Rd Ste C
Waukesha, WI 53186-1871
Phone: (864) 501-0751
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1932935962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jody Addair — Clinical Ops Project Coordinator · (317) 556-0017
Other names Proactive Md Family Health Center
NPI enumeratedSeptember 9, 2024
Last updated in NPPESSeptember 9, 2024
Certification dateSeptember 8, 2024
Mailing address124 Allawood Ct, Simpsonville, SC 29681-6207

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