PREMIERE SPINE AND SPORTS MEDICINE LLC
NPI 1245760875
Physical Medicine & Rehabilitation in Hagerstown, MD
About Premiere Spine And Sports Medicine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIERE SPINE AND SPORTS MEDICINE LLC (NPI 1245760875) is a healthcare organization registered as a physical medicine & rehabilitation in Hagerstown, Maryland and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through November 18, 2027, maintains a secondary practice location in Hagerstown, and lists Christopher David Clark, Owner/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premiere Spine And Sports Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Premiere Spine And Sports Medicine LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 21D2334316
Premier Spine And Sports Medicine LLC · Hagerstown, MDFrequently 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 Premiere Spine And Sports Medicine LLC's NPI number?
The NPI number for Premiere Spine And Sports Medicine LLC is 1245760875. It was assigned to this organization in the NPPES registry on June 15, 2017.
Where is Premiere Spine And Sports Medicine LLC located?
Premiere Spine And Sports Medicine LLC is located at 13114 Pennsylvania Ave, Hagerstown, MD 21742. The listed phone number is (301) 800-7770.
What is Premiere Spine And Sports Medicine LLC's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.
Is Premiere Spine And Sports Medicine LLC enrolled in Medicare?
Yes. Premiere Spine And Sports Medicine LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premiere Spine And Sports Medicine LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Premiere Spine And Sports Medicine LLC, in Interventional Pain Management and Physical Therapist in Private Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Premiere Spine And Sports Medicine LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2334316) is associated with this NPI, valid through November 18, 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 Premiere Spine And Sports Medicine LLC was last updated on November 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.