PREMIER MEDICAL GROUP LLC (NPI# 1447899448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447899448 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL GROUP LLC |
| Practice Address |
4550 E Charleston Blvd Las Vegas NV 89104-5525 |
| Mailing Address |
4012 S Rainbow Blvd Ste K532 Las Vegas NV 89103-2010 |
| Practice Telephone | 7026238810 |
| Practice Fax Number | 7029268822 |
| Mailing Telephone | 7023280787 |
| Mailing Fax Number | 7029268822 |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2019-12-23 |
| Authorized Official Name | VANESSA TORRES (ADMINISTRATOR) |
| Authorized Official Telephone | 7027699444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WG0000X |
Registered Nurse Specialization: General Practice |
Nursing Service Providers | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities | ||
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| N | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities | ||
| N | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities | ||
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| N | 343800000X | Secured Medical Transport (VAN) | Transportation Services | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 S Rainbow Blvd Ste 200, Las Vegas, NV 891456231 | 7029636363 | 7029268822 |
| 825 S Main Street, Tonopah, NV 89049 | 7029636363 | 7029268822 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PREMIER MEDICAL GROUP LLC | 325 Merrick Ave, East Meadow, New York 11554 |
| Street Address |
4550 E CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-5525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205890027 | Simmon L Wilcox | Emergency Medicine | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2006-04-17 |
| 1205451382 | Christian Ceasar Lapitan | Nurse Practitioner | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2020-06-14 |
| 1336707900 | Lab Express LLC | Durable Medical Equipment & Medical Supplies | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2019-05-30 |
| 1235657149 | Sneha Vinod Philip Thomas | Nurse Practitioner | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2017-08-31 |
| 1750748620 | Lab Express, LLC | Durable Medical Equipment & Medical Supplies | 4550 E Charleston Blvd, Las Vegas, NV 89104 | 2016-01-25 |
| 1164833638 | David M Pena Sariol | Massage Therapist | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2014-05-18 |
| 1275944027 | John Thao | Respiratory Therapist, Certified | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2014-05-14 |
| 1881014579 | Nolimits Nutrition & Wellness, LLC | Clinic/Center | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2014-04-21 |
| 1841613650 | Nommis Consultants | Emergency Medicine | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2014-01-30 |
| 1972684629 | Musnitanandvazquezltd | Family Medicine | 4550 E Charleston Blvd, Las Vegas, NV 89104-5525 | 2006-10-18 |
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|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 1396398947 | Martinez Antuan Coates | Psychologist | 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 | 2019-07-23 |
| 1982171518 | Ian Sande | Occupational Therapist | 1500 West Warm Springs Rd, Las Vegas, NV 89104 | 2018-11-01 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1023420759 | Women's Cancer Center Division of Colorectal Surgery | Clinic/Center | 3131 La Canada St Ste 241, Las Vegas, NV 89169-2588 | 2014-05-29 |
| 1063849313 | Rutishauser LLC | Clinic/Center | 3061 S. Maryland Pkwy, Suite #104, Las Vegas, NV 89109-6226 | 2013-10-02 |
| 1518196765 | Oband Bernstein Medical Group, Ltd | Clinic/Center | 4440 South Eastern Ave, Las Vegas, NV 89119-7825 | 2009-07-09 |
| 1750568754 | Las Vegas Family Clinic | Clinic/Center | 1311 S Casino Center Blvd, Las Vegas, NV 89104-1105 | 2008-01-22 |
| 1619582830 | Lend A Hand LLC | Clinic/Center | 4091 Asante Cove St, Las Vegas, NV 89115-3511 | 2020-09-14 |
| 1558974055 | Care First Clinic LLC | Clinic/Center | 7488 W Sahara Ave, Las Vegas, NV 89117-2740 | 2020-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.