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Organization
PDS GROUP LLC
Active
Organization
PDS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES PENTICUFF JR. (MANAGING MEMBER)
(317) 349-7680
Entity
Organization
Contact information
Practice address
2550 S FLAT ROCK RD, BLOOMINGTON, IN 47403-3285
(317) 349-7680
(833) 975-0724
Mailing address
2550 S FLAT ROCK RD, BLOOMINGTON, IN 47403-3285
(317) 349-7680
(833) 975-0724
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
—
NULL
163WA2000X
Administrator Registered Nurse
—
—
163WC0400X
Case Management Registered Nurse
—
NULL
163WC0400X
Case Management Registered Nurse
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
174H00000X
Health Educator
Primary
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
246QM0706X
Medical Technologist
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/21/2023
Last updated
07/23/2026
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