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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PDS GROUP LLC
NPI 1366122566
Nurse Practitioner in Bloomington, IN

Active since July 21, 2023CLIA 15D2322902 · Waiver
2550 S FLAT ROCK RD, BLOOMINGTON, IN 47403(317) 349-7680(833) 975-0724 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 23, 2026, Jul 14, 2026, Sep 9, 2024 and 2 more (5 updates tracked since 2023).

About Pds Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PDS GROUP LLC (NPI 1366122566) is a healthcare organization registered as a nurse practitioner in Bloomington, Indiana and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through April 28, 2027 and lists James Penticuff, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1366122566
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePDS GROUP LLC
Location Address2550 S FLAT ROCK RDBloomington, IN 47403-3285
Mailing Address2550 S Flat Rock RdBloomington, IN 47403-3285 · (317) 349-7680 · Fax (833) 975-0724
Phone(317) 349-7680
Fax(833) 975-0724
Organization SubpartNo
Authorized OfficialJames PenticuffManaging Member · (317) 349-7680
Enumeration DateJuly 21, 2023
Last NPPES UpdateJuly 23, 20265 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1366122566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered Nurse · AdministratorTaxonomy 163WA2000X
Also ListedRegistered Nurse · Case ManagementTaxonomy 163WC0400X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
2550 S FLAT ROCK RD, Bloomington, IN 47403
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2322902

Pds Group LLC · Bloomington, IN
Active · expires Apr 28, 2027
CLIA Number15D2322902
Laboratory TypePractitioner Other
Certificate Effective DateApril 29, 2025
Certificate Expiration DateApril 28, 2027
Laboratory DirectorJohn D. Heflin
Laboratory Phone(317) 349-7680
Laboratory LocationPds Group LLC2559 S Addisyn Lane, Bloomington, IN 47403
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ODYSSEY WELLNESS INC
Nurse Practitioner
2550 S FLAT ROCK RD
BLOOMINGTON, IN 47403
Monroe County (317) 349-7680
RONIT L REUVENY CNM, FNP-C
Nurse Practitioner (Family)
2550 S FLAT ROCK RD
BLOOMINGTON, IN 47403
Monroe County (317) 349-7680
ODYSSEY ENTERPRISES LLC
Nurse Practitioner
2550 S FLAT ROCK RD
BLOOMINGTON, IN 47403
Monroe County (317) 349-7680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pds Group LLC's NPI number?

The NPI number for Pds Group LLC is 1366122566. It was assigned to this organization in the NPPES registry on July 21, 2023.

Where is Pds Group LLC located?

Pds Group LLC is located at 2550 S Flat Rock Rd, Bloomington, IN 47403. The listed phone number is (317) 349-7680.

What is Pds Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Pds Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2322902) is associated with this NPI, valid through April 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pds Group LLC was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.