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CENTERWELL SENIOR PRIMARY CARE- GROVE PARK
NPI 1013672815
Internal Medicine in Atlanta, GA

Active since November 05, 2021CLIA 11D2261240 · Waiver
2056 DONALD LEE HOLLOWELL PKWY NW STE 1, ATLANTA, GA 30318(470) 890-3910(877) 445-5270 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 3, 2024, Oct 14, 2022, Nov 5, 2021 (3 updates tracked since 2021).

About Centerwell Senior Primary Care- Grove Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTERWELL SENIOR PRIMARY CARE- GROVE PARK (NPI 1013672815) is a healthcare organization registered as an internal medicine in Atlanta, Georgia and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through May 26, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1013672815
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE GA PC
Location Address2056 DONALD LEE HOLLOWELL PKWY NW STE 1Atlanta, GA 30318-4764
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(470) 890-3910
Fax(877) 445-5270
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateNovember 5, 2021
Last NPPES UpdateJuly 3, 20243 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
✔ NPI 1013672815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
2056 DONALD LEE HOLLOWELL PKWY NW STE 1, Atlanta, GA 30318
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Other Names 1

Doing Business AsCenterwell Senior Primary Care- Grove Park

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2261240

Centerwell Senior Primary Care - Grove Park · Atlanta, GA
Active · expires May 26, 2028
CLIA Number11D2261240
Laboratory TypePhysician Office
Certificate Effective DateMay 27, 2026
Certificate Expiration DateMay 26, 2028
Laboratory DirectorErica Savage-Jeter
Laboratory Phone(470) 890-3910
Laboratory LocationCenterwell Senior Primary Care - Grove Park2056 Donald Lee Hollowell Parkway, NW, Suite 1, Atlanta, GA 30318
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centerwell Senior Primary Care Ga PC's NPI number?

The NPI number for Centerwell Senior Primary Care Ga PC is 1013672815. It was assigned to this organization in the NPPES registry on November 5, 2021. The provider is doing business as Centerwell Senior Primary Care- Grove Park.

Where is Centerwell Senior Primary Care Ga PC located?

Centerwell Senior Primary Care Ga PC is located at 2056 Donald Lee Hollowell Pkwy NW Ste 1, Atlanta, GA 30318. The listed phone number is (470) 890-3910.

What is Centerwell Senior Primary Care Ga PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Centerwell Senior Primary Care Ga PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2261240) is associated with this NPI, valid through May 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Ga PC was last updated on July 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.