MEDICARE: OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1225998966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1433
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03802-1433
Country	:	US
Telephone Number	:	866-434-3255
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 ALLOY WAY
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-8354
Country	:	US
Telephone Number	:	704-292-7152
Fax Number	:

Authorized Official
Title or Position	:	SR. VP CORPORATE MEDICAL DIRECTOR
Name	:	TERRY LAYMAN
Credential	:	MD
Telephone Number	:	866-434-3255

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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