Premier Medical Group, LLC
NPI 1104649946 · Substance Use Disorder Rehabilitation Clinic/Center · Bloomington, IN
Premier Medical Group, LLC is a Substance Use Disorder Rehabilitation Clinic/Center organization in Bloomington, IN (NPI 1104649946).
Provider details
- NPI number
- 1104649946
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kirill Vesselov, Manager(561) 556-3721
Specialties & taxonomies
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-10-31
- Last updated
- 2024-12-06
- Certified
- 2024-12-06
Frequently asked questions
- What is Premier Medical Group, LLC's NPI number?
- Premier Medical Group, LLC's National Provider Identifier (NPI) is 1104649946, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Premier Medical Group, LLC?
- Premier Medical Group, LLC is classified in the NPPES registry as Substance Use Disorder Rehabilitation Clinic/Center (Ambulatory Health Care Facilities).
- Where is Premier Medical Group, LLC located?
- Premier Medical Group, LLC's practice location on file with NPPES is 409 W 1st St, Bloomington, IN 47403-2403.
- What is Premier Medical Group, LLC's phone number?
- The practice phone number listed in the NPPES registry for Premier Medical Group, LLC is (561) 556-3721.
- Who is the authorized official for Premier Medical Group, LLC?
- The authorized official listed on Premier Medical Group, LLC's NPPES record is Kirill Vesselov, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Premier Medical Group, LLC's NPI active?
- Yes — Premier Medical Group, LLC's NPI (1104649946) is active in the NPPES registry as of the last update on 2024-12-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.