| Premier Medical Group Pc | |
|
490 Dunlop Ln Clarksville TN 37040-5007 | |
| (931) 245-7000 | |
| Not Available |
| Full Name | Premier Medical Group Pc |
|---|---|
| Speciality | General Practice |
| Location | 490 Dunlop Ln, Clarksville, Tennessee |
| Authorized Official Name and Position | Melissa Liverett (CHIEF FINANCIAL ADMINISTRATOR) |
| Authorized Official Contact | 9312457000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Group Pc Po Box 3799 Clarksville TN 37043-3799 Ph: (931) 245-7000 | Premier Medical Group Pc 490 Dunlop Ln Clarksville TN 37040-5007 Ph: (931) 245-7000 |
| NPI Number | 1740242957 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 09/23/2025 |
| Medicare PECOS PAC ID | 9739084088 |
|---|---|
| Medicare Enrollment ID | O20031201000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740242957 | NPI | - | NPPES |
| 3164217 | Other | TN | BCBS GROUP # |
| CA4837 | Other | TN | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | James P Darke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376528968 PECOS PAC ID: 2264426642 Enrollment ID: I20040408001480 |
| Provider Name | Jeffrey L Hamre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902897416 PECOS PAC ID: 3577525096 Enrollment ID: I20041027001117 |
| Provider Name | Jyotsna P Korivi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699713024 PECOS PAC ID: 1355346412 Enrollment ID: I20060922000377 |
| Provider Name | Bradley S Vander Veen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558336487 PECOS PAC ID: 6002914199 Enrollment ID: I20070613000702 |
| Provider Name | Joseph Kosinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154435501 PECOS PAC ID: 6002917481 Enrollment ID: I20070730000428 |
| Provider Name | David G Johnston |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790766046 PECOS PAC ID: 7113017930 Enrollment ID: I20080429000891 |
| Provider Name | Stephanie L Schultz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326020520 PECOS PAC ID: 8022108513 Enrollment ID: I20080430000115 |
| Provider Name | Deborah B Hellums |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972549673 PECOS PAC ID: 1355353616 Enrollment ID: I20080926000193 |
| Provider Name | George E Lu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386635001 PECOS PAC ID: 9931299757 Enrollment ID: I20081231000412 |
| Provider Name | Jacqueline D Milam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972584993 PECOS PAC ID: 1759471576 Enrollment ID: I20090115000730 |
| Provider Name | Tommy Lee Carman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710968250 PECOS PAC ID: 3577653393 Enrollment ID: I20090804000345 |
| Provider Name | Jeffrey V Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144201567 PECOS PAC ID: 0941390769 Enrollment ID: I20100219000020 |
| Provider Name | Daniel Rea Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144211871 PECOS PAC ID: 2668562489 Enrollment ID: I20100812000177 |
| Provider Name | Lance Sherley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518958966 PECOS PAC ID: 9830289651 Enrollment ID: I20100812000716 |
| Provider Name | Greta C Manning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922058957 PECOS PAC ID: 8224123377 Enrollment ID: I20100902000408 |
| Provider Name | Giriprasadarao Korivi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093706756 PECOS PAC ID: 6709948680 Enrollment ID: I20101006000756 |
| Provider Name | Pam Lassiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629374632 PECOS PAC ID: 5092993238 Enrollment ID: I20110617000167 |
| Provider Name | Ashley B Walker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568691871 PECOS PAC ID: 1254596786 Enrollment ID: I20120706000122 |
| Provider Name | Di'net Sintim-amoah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760667430 PECOS PAC ID: 9133375421 Enrollment ID: I20120801000571 |
| Provider Name | Gale E Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437315470 PECOS PAC ID: 3577607035 Enrollment ID: I20130128000255 |
| Provider Name | Chae Ko |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1871721563 PECOS PAC ID: 7214182625 Enrollment ID: I20130820000541 |
| Provider Name | Shaun Kueter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851381644 PECOS PAC ID: 3779756259 Enrollment ID: I20140411000316 |
| Provider Name | Kevin S Preston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437313202 PECOS PAC ID: 9335366533 Enrollment ID: I20150804004350 |
| Provider Name | Jaquetta J Wolf-king |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699179135 PECOS PAC ID: 2567778525 Enrollment ID: I20150904002171 |
| Provider Name | Valerie Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033655964 PECOS PAC ID: 6608152301 Enrollment ID: I20170412001192 |
| Provider Name | Katie Greene Pegram |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780977207 PECOS PAC ID: 1153567797 Enrollment ID: I20170703001236 |
| Provider Name | Douglas Snodgrass |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750671798 PECOS PAC ID: 2961778881 Enrollment ID: I20171020002062 |
| Provider Name | Katelyn M Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396273157 PECOS PAC ID: 7618222944 Enrollment ID: I20180609000046 |
| Provider Name | Nimit Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568874238 PECOS PAC ID: 5294030748 Enrollment ID: I20180801001824 |
| Provider Name | Mary Gluff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700247822 PECOS PAC ID: 4688964711 Enrollment ID: I20180830001265 |
| Provider Name | Crystal Vernon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336163948 PECOS PAC ID: 5092712679 Enrollment ID: I20181112001460 |
| Provider Name | Cherilyn Anne White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578541926 PECOS PAC ID: 1759350069 Enrollment ID: I20181217000440 |
| Provider Name | Crystal Lynn Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154801207 PECOS PAC ID: 5597001818 Enrollment ID: I20190108001682 |
| Provider Name | Devona Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477025328 PECOS PAC ID: 2860732948 Enrollment ID: I20190327003347 |
| Provider Name | Kwame Frimpong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053775262 PECOS PAC ID: 5193157188 Enrollment ID: I20191113000216 |
| Provider Name | Sonia Lanae Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760879993 PECOS PAC ID: 0244651768 Enrollment ID: I20200608003115 |
| Provider Name | Millie Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518358118 PECOS PAC ID: 0749591089 Enrollment ID: I20210219000465 |
| Provider Name | Melanie Cheree Mantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700181443 PECOS PAC ID: 4587887526 Enrollment ID: I20210224000828 |
| Provider Name | Lindsey Marie Gendreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194260976 PECOS PAC ID: 7315224359 Enrollment ID: I20210224001431 |
| Provider Name | Mary Eve Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154531127 PECOS PAC ID: 1951587088 Enrollment ID: I20210316002001 |
| Provider Name | Anne Gunn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912264854 PECOS PAC ID: 3577872357 Enrollment ID: I20210406002095 |
| Provider Name | Genevieve Mae Febbraro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154821031 PECOS PAC ID: 5991108375 Enrollment ID: I20210722001425 |
| Provider Name | Aaron Carson Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699213868 PECOS PAC ID: 6406125095 Enrollment ID: I20220120002286 |
| Provider Name | Christine Beyke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326426792 PECOS PAC ID: 8426347675 Enrollment ID: I20220408001584 |
| Provider Name | Ebony Leann Mullen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992267306 PECOS PAC ID: 0749662286 Enrollment ID: I20220801001648 |
| Provider Name | Katherine Bruss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720441926 PECOS PAC ID: 2668760554 Enrollment ID: I20220824003832 |
| Provider Name | Michael E Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427187673 PECOS PAC ID: 4385743517 Enrollment ID: I20221004001748 |
| Provider Name | Megan Guerra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154615201 PECOS PAC ID: 1557683588 Enrollment ID: I20221114001418 |
| Provider Name | Sarah Nicole Maccini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124740881 PECOS PAC ID: 9436528536 Enrollment ID: I20221213000518 |
| Provider Name | Jordan Gass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356791537 PECOS PAC ID: 6406140722 Enrollment ID: I20230601002141 |
| Provider Name | Kyle Burner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336695717 PECOS PAC ID: 7214202209 Enrollment ID: I20230612000642 |
| Provider Name | Erin Marie Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891332110 PECOS PAC ID: 0547622201 Enrollment ID: I20230811000958 |
| Provider Name | Kara Emerton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093472375 PECOS PAC ID: 3577913136 Enrollment ID: I20231221002904 |
| Provider Name | Madison Cheyenne Buchanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114777604 PECOS PAC ID: 1850731654 Enrollment ID: I20240426001827 |
| Provider Name | Roberto Tapia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053940023 PECOS PAC ID: 0648716613 Enrollment ID: I20240725004213 |
| Provider Name | Peter P. Rajtar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356613376 PECOS PAC ID: 4284957374 Enrollment ID: I20241115003939 |
| Provider Name | Sandra Bosman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669650164 PECOS PAC ID: 4183763675 Enrollment ID: I20250108002620 |
Clarksville Surgical Associates, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 647 Dunlop Lane, Suite 100, Clarksville, TN 37040 Phone: 931-551-8991 Fax: 931-551-4053 | |
Center For Pulmonary & Sleep Medicine, Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 298 Clear Sky Ct, Ste B, Clarksville, TN 37043 Phone: 931-542-2647 Fax: 931-542-2648 | |
Matthew Walker Comprehensive Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 Dover Rd, Clarksville, TN 37042 Phone: 931-920-5000 Fax: 615-320-6033 | |
Medical Direct Care, Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 190 Hatcher Lane, Suite B, Clarksville, TN 37040 Phone: 931-221-0902 Fax: 931-221-0602 | |
Nebben Physical Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 282 Clear Sky Ct, Clarksville, TN 37043 Phone: 931-647-1199 Fax: 931-647-7010 | |
Stephen A. White, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2289 B Rudolphtown Road, Clarksville, TN 37043 Phone: 931-552-3031 Fax: 931-552-9820 | |
Cool Springs Allergy Associates Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 Hillcrest Dr, Suite 101, Clarksville, TN 37043 Phone: 931-645-5689 |