CENTERWELL SENIOR PRIMARY CARE-GREEN VALLEY
NPI 1053029488
Internal Medicine in Las Vegas, NV

Q: What is Centerwell Senior Primary Care (nv) PC's specialty?

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

Active since November 15, 2022CLIA 29D2280482 · Waiver

2381 E WINDMILL LN STE 14, LAS VEGAS, NV 89123(702) 344-2936(877) 707-4582 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 3, 2024, Aug 11, 2023, Jul 27, 2023 and 1 more (4 updates tracked since 2022).

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About Centerwell Senior Primary Care-green Valley NPPES

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

CENTERWELL SENIOR PRIMARY CARE-GREEN VALLEY (NPI 1053029488) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through April 18, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1053029488

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC

Location Address2381 E WINDMILL LN STE 14Las Vegas, NV 89123-2069

Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000

Phone(702) 344-2936

Fax(877) 707-4582

Organization SubpartYes

Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120

Enumeration DateNovember 15, 2022

Last NPPES UpdateJuly 3, 20244 updates tracked since enumeration

NPPES CertifiedJuly 3, 2024

✔ NPI 1053029488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X

Also ListedGeneral PracticeTaxonomy 208D00000X

2381 E WINDMILL LN STE 14, Las Vegas, NV 89123

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Other Names 1

Doing Business AsCenterwell Senior Primary Care-green Valley

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 29D2280482

Centerwell Senior Primary Care- Green Valley · Las Vegas, NV

Active · expires Apr 18, 2027

CLIA Number29D2280482

Laboratory TypePhysician Office

Certificate Effective DateApril 19, 2025

Certificate Expiration DateApril 18, 2027

Laboratory DirectorTracy J Wakefield

Laboratory Phone(725) 258-2980

Laboratory LocationCenterwell Senior Primary Care- Green Valley2381 E Windmill Lane Suite 14, Las Vegas, NV 89123

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HARSAHIBA KAUR MD

Family Medicine