NPIMap

Individual provider Active NPI

Mariyam Yasmeen Houston, DO

  • Family Medicine Physician
  • Normal, IL
National Provider Identifier
1407417306
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02007922A Issued in IN
Practice address
1300 Franklin Ave Ste 110
Normal, IL 61761-3799
Phone
(309) 268-3558
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125079101 IL
Pediatrics Physician 208000000X 8579 NE
Family Medicine Physician 207Q00000X 02007922A IN Primary

Addresses

Primary practice location

1300 Franklin Ave Ste 110
Normal, IL 61761-3799

Mailing address

1300 Franklin Ave
Ste 110
Normal, IL 61761-3799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807003583 IN Practitioner - Family Practice 4789915729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1530 N 7TH St
Suite 201
Terre Haute, IN 47807-1061
Phone (812) 238-7631

221 S 6 TH St
Apands Clinic Downtown
Terre Haute, IN 47807-4214
Phone (812) 232-0564

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Union Associated Physicians Clinic, LLC Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Valley Professionals Community Health Center Inc Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Valley Professionals Community Health Center, Inc. Current Accepting new patients
Valley Professionals Community Health Center Inc CurrentSince Dec 1, 2024 Accepting new patients
Union Associated Physicians Clinic LLC Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Nebraska Medical Center Past Accepting new patients

Locations

777 S Main St
Ste 100
Clinton, IN 47842
Phone (765) 828-1003

1530 N 7th St
Ste 201
Terre Haute, IN 47807
Phone (812) 238-7631

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1407417306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "STE 110",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE STE 110",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613799",
            "telephone_number": "309-268-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "MARIYAM",
        "middle_name": "YASMEEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125079101",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "8579",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02007922A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.