NPIMap

Organization Active NPI

Ourhealth Professional Physician Group, LLC

  • Clinic/Center
  • Bloomington, IN
National Provider Identifier
1881467017
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC
Practice address
121 N Pete Ellis Dr Ste 102
Bloomington, IN 47408-4460
Phone
(866) 434-3255
NPI assigned
Oct 31, 2023
Last updated
Dec 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Dr. Terry Layman, MD
Title
SVP, Corporate Medical Director
Phone
(317) 727-8698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

121 N Pete Ellis Dr Ste 102
Bloomington, IN 47408-4460

Mailing address

10 W Market St Ste 2900
Indianapolis, IN 46204-2964

Other names 1

  • Marathon Health at East Bloomington Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2299806Marathon Health East Bloomington121 N Pete Ellis Drive, Suite 102, Bloomington, IN 47408Certificate of waiverFeb 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Independent Physician Group of Illinois LLC69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

121 N Pete Ellis Dr
Bloomington, IN 47408

121 N Pete Ellis Dr
Ste 102
Bloomington, IN 47408

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1881467017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W MARKET ST STE 2900",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N PETE ELLIS DR STE 102",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474084460",
            "telephone_number": "866-434-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "LAYMAN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "SVP, CORPORATE MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "317-727-8698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marathon Health at East Bloomington",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Marathon Health at East Bloomington",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.