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PREMIER VILLAGE PHYSICIANS, LLC
NPI 1134052053
Family Medicine in Fishers, IN

Active since June 08, 2026CLIA 15D2337935 · Waiver
12680 LONGLEAF LN, FISHERS, IN 46038(317) 777-0628(317) 342-3117 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Premier Village Physicians, Llc NPPES

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

PREMIER VILLAGE PHYSICIANS, LLC (NPI 1134052053) is a healthcare organization registered as a family medicine in Fishers, Indiana and active in the NPI registry since June 2026. The organization holds a CLIA Waiver certificate valid through February 2, 2028 and lists Tyler Vernon, Owner, Ceo, Physician, as its authorized official.

NPPES Registry Identity

NPI1134052053
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePREMIER VILLAGE PHYSICIANS, LLC
Location Address12680 LONGLEAF LNFishers, IN 46038-9188
Mailing Address12680 Longleaf LnFishers, IN 46038-9188 · (317) 777-0628 · Fax (317) 342-3117
Phone(317) 777-0628
Fax(317) 342-3117
Organization SubpartNo
Authorized OfficialTyler VernonOwner, Ceo, Physician · (317) 777-0628
Enumeration DateJune 8, 2026
NPPES CertifiedJune 8, 2026
✔ NPI 1134052053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12680 LONGLEAF LN, Fishers, IN 46038
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 15D2337935

Premier Village Physicians · Fishers, IN
Active · expires Feb 2, 2028
CLIA Number15D2337935
Laboratory TypeMobile Laboratory
Certificate Effective DateFebruary 3, 2026
Certificate Expiration DateFebruary 2, 2028
Laboratory DirectorTyler L. Vernon
Laboratory Phone(317) 777-0628
Laboratory LocationPremier Village Physicians12680 Longleaf Ln, Fishers, IN 46038
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Village Physicians, LLC's NPI number?

The NPI number for Premier Village Physicians, LLC is 1134052053. It was assigned to this organization in the NPPES registry on June 8, 2026.

Where is Premier Village Physicians, LLC located?

Premier Village Physicians, LLC is located at 12680 Longleaf Ln, Fishers, IN 46038. The listed phone number is (317) 777-0628.

What is Premier Village Physicians, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Premier Village Physicians, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2337935) is associated with this NPI, valid through February 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premier Village Physicians, LLC was last updated on June 8, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.