Individual provider Active NPI

Matthew Layman, PHARMD

  • Pharmacist
  • Normal, IL
National Provider Identifier
1487290631
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051293575 Issued in IL
Practice address
1550 E College Ave
Normal, IL 61761-2120
Phone
(309) 452-0839
NPI assigned
Nov 22, 2019
Last updated
Nov 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051293575 IL Primary

Addresses

Primary practice location

1550 E College Ave
Normal, IL 61761-2120

Mailing address

411 Labrador LN
Normal, IL 61761-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051293575ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I CurrentSince Apr 27, 2025 Accepting new patients
Kroger Limited Partnership I PastSince Nov 24, 2019 Accepting new patients

Locations

1550 E College Ave
Normal, IL 61761
Phone (309) 452-0839

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1487290631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 LABRADOR LN",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E COLLEGE AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612120",
            "telephone_number": "309-452-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYMAN",
        "first_name": "MATTHEW",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051293575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.