CENTERWELL SENIOR PRIMARY CARE-GULFPORT
NPI 1003528092
Internal Medicine in Gulfport, MS

NPI Status: Active since December 21, 2022

Contact Information

12057 HIGHWAY 49 STE C
GULFPORT, MS
ZIP 39503
Phone: (228) 832-9385
Fax: (877) 504-6444

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  • Organization
  • Internal Medicine
  • CLIA Number: 25D2278609
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-20-2027

About CENTERWELL SENIOR PRIMARY CARE-GULFPORT

This page provides the complete NPI Profile along with additional information for Centerwell Senior Primary Care-gulfport, an internist established in Gulfport, Mississippi operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1003528092 assigned on December 2022. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Centerwell Senior Primary Care-gulfport operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Centerwell Senior Primary Care-gulfport. The authorized official of this NPI record is Angie Martinez (Senior Credentialing Professional)

NPI
1003528092
Provider Legal Name
CENTERWELL SENIOR PRIMARY CARE MS PC
Other Organization Name
CENTERWELL SENIOR PRIMARY CARE-GULFPORT
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12057 HIGHWAY 49 STE C GULFPORT, MS 39503
Location Phone
(228) 832-9385
Location Fax
(877) 504-6444
Mailing Address
6101 BLUE LAGOON DR STE 200 MIAMI, FL 33126
Mailing Phone
(305) 500-2000
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-21-2022
Last Update Date
07-03-2024
Code Navigator

An internist like Centerwell Senior Primary Care-gulfport is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
2208D00000XAllopathic & Osteopathic Physicians

General Practice

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANGIE MARTINEZ

Authorized Official Title
SENIOR CREDENTIALING PROFESSIONAL
Authorized Official Phone
(407) 447-7120

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
25D2278609
Facility Type
Physician Office
Certificate Effective Date
March 21, 2025
Certificate Expiration Date
March 20, 2027
Laboratory Director
DR. EARL K. MAGEE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Centerwell Senior Primary Care-gulfport to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003528092, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
2
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 8 → 16 → 7 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 1 + 0 + 2 + 1 + 6 + 0 + 1 + 8 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1003528092.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
12057 HIGHWAY 49 STE C
GULFPORT, MS 39503
Family Medicine
12057 HIGHWAY 49 STE C
GULFPORT, MS 39503
Nurse Practitioner (Family)
12057 HIGHWAY 49 STE C
GULFPORT, MS 39503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003528092, enumerated as an "organization" on December 21, 2022.

The provider is located at 12057 HIGHWAY 49 STE C GULFPORT, MS 39503 and the phone number is (228) 832-9385.

Internal Medicine with taxonomy code 207R00000X.