Active NPI
Hoosier Wellness Operating Subsidiary, LLC
- Multi-Specialty Clinic/Center
- Bloomington, IN
National Provider Identifier
1730753294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- HOOSIER WELLNESS OPERATING SUBSIDIARY, LLC
- Practice address
- 421 W 1St St
Bloomington, IN 47403-2403 - Phone
- (574) 703-4706
- NPI assigned
- May 18, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tara Gurney
- Title
- Authorized Official
- Phone
- (561) 517-3400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
421 W 1St St
Bloomington, IN 47403-2403
Mailing address
2925 10TH Ave N
Palm Springs, FL 33461-3000
Other practice location 1
2529 Schuyler Ave Ste 700-A
Lafayette, IN 47905-3979
Phone (561) 461-3791
Other practice location 2
7900 W Jefferson Blvd Ste A
Fort Wayne, IN 46804-4128
Phone (561) 635-2400
Other practice location 3
215 W 4th St Ste 101
Mishawaka, IN 46544-1917
Phone (561) 461-3791
Other practice location 4
14555 Hazel Dell Pkwy Ste 140
Carmel, IN 46033-7234
Phone (844) 650-0064
Other practice location 5
1578 E 85th Ave
Merrillville, IN 46410-8900
Phone (561) 461-3791
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497891840 | Other | IN | MICHAEL KANE |
| 1467936070 | Other | IN | DAWN JOHNSON |
National Provider Directory
National Provider Directory- Tax ID family
- Hoosier Wellness Providers LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1023886488
Locations
14555 Hazel Dell Pkwy
Ste 140
Carmel, IN 46033
Phone (317) 569-0033
7900 W Jefferson Blvd
Ste A
Fort Wayne, IN 46804
Phone (260) 370-8955
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Indianapolis, IN
- NPI 1255057766
-
- Psychiatry Physician
- Bloomington, IN
- NPI 1497891840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789084800000",
"number": "1730753294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 10TH AVE N",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334613000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 W 1ST ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032403",
"telephone_number": "574-703-4706"
}
],
"practiceLocations": [
{
"address_1": "2529 Schuyler Ave Ste 700-A",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "IN",
"postal_code": "479053979",
"country_code": "US",
"telephone_number": "561-461-3791",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7900 W Jefferson Blvd Ste A",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468044128",
"country_code": "US",
"telephone_number": "561-635-2400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "215 W 4th St Ste 101",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465441917",
"country_code": "US",
"telephone_number": "561-461-3791",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14555 Hazel Dell Pkwy Ste 140",
"address_purpose": "LOCATION",
"city": "Carmel",
"state": "IN",
"postal_code": "460337234",
"country_code": "US",
"telephone_number": "844-650-0064",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1578 E 85th Ave",
"address_purpose": "LOCATION",
"city": "Merrillville",
"state": "IN",
"postal_code": "464108900",
"country_code": "US",
"telephone_number": "561-461-3791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "HOOSIER WELLNESS OPERATING SUBSIDIARY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-18",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A",
"authorized_official_last_name": "GURNEY",
"authorized_official_first_name": "TARA",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "561-517-3400"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHAEL KANE",
"identifier": "1497891840",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAWN JOHNSON",
"identifier": "1467936070",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.