PREMIER MEDICAL GROUP, LLC (NPI# 1639468788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639468788 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL GROUP, LLC |
| Other Organization Name | OB/GYN CARE ASSOCIATES, SC |
| Practice Address |
1505 Eastland Dr Ste 500 Bloomington IL 61701-7905 |
| Practice Telephone | 3096622273 |
| Practice Fax Number | 3096622014 |
| Mailing Telephone | 3096622273 |
| Mailing Fax Number | 3096622014 |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |
| Authorized Official Name | JOHN HESSE (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 3096626200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 36-101512 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| OB/GYN Care Associates, SC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427357227 | Premier Medical Group, LLC | Urology | 1401 Eastland Dr Ste B, Bloomington, IL 61701-3514 | 2011-03-18 |
| 1942501978 | Premier Medical Group, LLC | Family Medicine | 2102 E Washington St, Bloomington, IL 61701-4321 | 2010-11-08 |
| 1275825432 | Premier Medical Group, LLC | Orthopaedic Surgery | 2005 Jacobssen Dr, Suite A, Normal, IL 61761-6287 | 2011-05-06 |
| 1184913881 | Premier Medical Group, LLC | Obstetrics & Gynecology | 1300 Franklin Ave, Suite 360, Normal, IL 61761-3592 | 2011-04-04 |
| 1891084653 | Premier Medical Group, LLC | Obstetrics & Gynecology | 107 N Regency Dr, Bloomington, IL 61701-3505 | 2011-04-01 |
| 1841589835 | Premier Medical Group, LLC | Internal Medicine | 1302 Franklin Ave, #4800, Normal, IL 61761-3551 | 2011-03-31 |
| 1720377690 | Premier Medical Group, LLC | Surgery | 1537 Fort Jesse Rd, Suite A, Normal, IL 61761-6192 | 2011-03-31 |
| 1487943593 | Premier Medical Group, LLC | Plastic Surgery | 1505 Eastland Dr, Suite 350, Bloomington, IL 61701-3534 | 2011-03-30 |
| 1497054720 | Premier Medical Group, LLC | Podiatrist | 1512 W Reynolds St Ste A, Pontiac, IL 61764-9788 | 2011-03-25 |
| 1992004683 | Premier Medical Group, LLC | Surgery | 1505 Eastland Dr, Suite 2300, Bloomington, IL 61701-3534 | 2011-03-21 |
| Street Address |
1505 EASTLAND DR STE 500 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-7905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174038822 | Daniel A Nord Md, Obstetrics and Gynecology | Obstetrics & Gynecology | 1505 Eastland Dr Ste 230, Bloomington, IL 61701-7906 | 2017-12-04 |
| 1710437967 | David Olson | Obstetrics & Gynecology | 8201 Creekside Cir, Bloomington, MN 55437-3836 | 2016-10-12 |
| 1922402395 | Robert Ross Neal Jr. | Obstetrics & Gynecology | 7917 Wyoming Ct, Bloomington, MN 55438-1092 | 2014-10-14 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| 1518237577 | Whole Woman's Health of The Twin Cities | Obstetrics & Gynecology | 8053 E Bloomington Fwy Ste 450, Bloomington, MN 55420-1031 | 2012-01-09 |
| 1780916403 | Joseph Ignatius Hamel Sr. | Obstetrics & Gynecology | 8006 Pennsylvania Rd, Bloomington, MN 55438-1135 | 2010-02-04 |
| 1962688895 | Brian William Cook | Obstetrics & Gynecology | 2920 Mcintire Drive, Suite 250, Bloomington, IN 47403 | 2008-01-10 |
| 1982780656 | Wendy K. Corning | Obstetrics & Gynecology | 383 S Park Ridge Rd, Suite 102, Bloomington, IN 47401-8574 | 2006-10-27 |
| 1841399540 | Elvia A Greathouse | Obstetrics & Gynecology | 415 W 1st St, Bloomington, IN 47403-2403 | 2006-09-21 |
| 1831209584 | Bamidele Ogunleye | Obstetrics & Gynecology | 2111 East Oakland Ave, Ste B, Bloomington, IL 61701-5783 | 2006-08-30 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.