PREMIER MEDICAL GROUP, LLC
NPI 1104649946
Clinic/Center - Rehabilitation, Substance Use Disorder in Bloomington, IN

Q: What is Premier Medical Group, LLC's NPI number?

The NPI number for Premier Medical Group, LLC is 1104649946. It was assigned to this organization in the NPPES registry on October 31, 2024.

Q: What is Premier Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since October 31, 2024

409 W 1ST ST, BLOOMINGTON, IN 47403(561) 556-3721 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2024, Nov 5, 2024 (2 updates tracked since 2024).

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About Premier Medical Group, Llc NPPES

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

PREMIER MEDICAL GROUP, LLC (NPI 1104649946) is a healthcare organization registered as a rehabilitation, substance use disorder in Bloomington, Indiana and active in the NPI registry since October 2024. The organization lists Kirill Vesselov, Manager, as its authorized official.

NPPES Registry Identity

NPI1104649946

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NamePREMIER MEDICAL GROUP, LLC

Location Address409 W 1ST STBloomington, IN 47403-2403

Mailing Address2925 10th Ave NPalm Springs, FL 33461-3000

Phone(561) 556-3721

Organization SubpartNo

Authorized OfficialKirill VesselovManager · (561) 556-3721

Enumeration DateOctober 31, 2024

Last NPPES UpdateDecember 6, 20242 updates tracked since enumeration

NPPES CertifiedDecember 6, 2024

✔ NPI 1104649946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X

409 W 1ST ST, Bloomington, IN 47403

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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 Premier Medical Group, LLC's NPI number?

The NPI number for Premier Medical Group, LLC is 1104649946. It was assigned to this organization in the NPPES registry on October 31, 2024.

Where is Premier Medical Group, LLC located?

Premier Medical Group, LLC is located at 409 W 1st St, Bloomington, IN 47403. The listed phone number is (561) 556-3721.

What is Premier Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Premier Medical Group, LLC was last updated on December 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.