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CENTERWELL SENIOR PRIMARY CARE- STATE AVENUE
NPI 1104347756
Internal Medicine in Kansas City, KS

Active since July 05, 2017CLIA 17D2136731 · Waiver
7527 STATE AVE, KANSAS CITY, KS 66112(913) 335-6986(855) 446-7151 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 2024, Oct 20, 2022, Feb 23, 2021 and 6 more (9 updates tracked since 2017).

About Centerwell Senior Primary Care- State Avenue NPPES

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

CENTERWELL SENIOR PRIMARY CARE- STATE AVENUE (NPI 1104347756) is a healthcare organization registered as an internal medicine in Kansas City, Kansas and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through September 13, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1104347756
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE KS PA
Location Address7527 STATE AVEKansas City, KS 66112-2815
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(913) 335-6986
Fax(855) 446-7151
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJuly 5, 2017
Last NPPES UpdateAugust 19, 20249 updates tracked since enumeration
NPPES CertifiedAugust 19, 2024
✔ NPI 1104347756 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
7527 STATE AVE, Kansas City, KS 66112
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Other Names 4

Doing Business AsCenterwell Senior Primary Care- State Avenue
Doing Business AsPartners In Primary Care- State Avenue
Former Legal Business NamePartners In Primary Care Tx Pa
Former Legal Business NamePartners Inprimary Care (ks), P.a.

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 17D2136731

Centerwell Senior Primary Care-State Avenue · Kansas City, KS
Active · expires Sep 13, 2027
CLIA Number17D2136731
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorStephanie Ikeme
Laboratory Phone(913) 335-6986
Laboratory LocationCenterwell Senior Primary Care-State Avenue7527 State Ave, Kansas City, KS 66112
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

ELIZABETH NEUBAUER PA
Physician Assistant
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6986
AMANDA NICOLE STANLEY APRN
Nurse Practitioner (Gerontology)
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6986
CENTERWELL PHARMACY, INC.
Pharmacy (Community/Retail Pharmacy)
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6990
DR. STEPHANIE A IKEME D.O.
Family Medicine
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6986
DR. ALEX LEIGH ROBERTS PHARM.D.
Pharmacist
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6990
CONNIE J PIEKARSKI ARNP
Nurse Practitioner (Adult Health)
7527 STATE AVE
KANSAS CITY, KS 66112
Wyandotte County (913) 335-6986

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 Ks PA's NPI number?

The NPI number for Centerwell Senior Primary Care Ks PA is 1104347756. It was assigned to this organization in the NPPES registry on July 5, 2017. The provider is doing business as Centerwell Senior Primary Care- State Avenue and Partners in Primary Care- State Avenue. The provider was formerly known as Partners in Primary Care TX PA and Partners inPrimary Care (KS), P.A..

Where is Centerwell Senior Primary Care Ks PA located?

Centerwell Senior Primary Care Ks PA is located at 7527 State Ave, Kansas City, KS 66112. The listed phone number is (913) 335-6986.

What is Centerwell Senior Primary Care Ks PA's specialty?

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

Does Centerwell Senior Primary Care Ks PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D2136731) is associated with this NPI, valid through September 13, 2027. 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 Ks PA was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.