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CENTERWELL SENIOR PRIMARY CARE-ROXBORO
NPI 1114623386
Internal Medicine in Durham, NC

Active since January 31, 2023CLIA 34D2278768 · Waiver
3500 N ROXBORO ST STE 1B, DURHAM, NC 27704(919) 578-3974(877) 723-2970 Get Directions Write a Review

NPPES record last updated: August 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 11, 2023, Jan 31, 2023 (2 updates tracked since 2023).

About Centerwell Senior Primary Care-roxboro NPPES

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

CENTERWELL SENIOR PRIMARY CARE-ROXBORO (NPI 1114623386) is a healthcare organization registered as an internal medicine in Durham, North Carolina and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through March 22, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1114623386
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE NC JV PC
Location Address3500 N ROXBORO ST STE 1BDurham, NC 27704-2985
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120
Phone(919) 578-3974
Fax(877) 723-2970
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJanuary 31, 2023
Last NPPES UpdateAugust 11, 20232 updates tracked since enumeration
NPPES CertifiedAugust 11, 2023
✔ NPI 1114623386 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
3500 N ROXBORO ST STE 1B, Durham, NC 27704
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Other Names 1

Doing Business AsCenterwell Senior Primary Care-roxboro

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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 34D2278768

Centerwell Senior Primary Care-Roxboro · Durham, NC
Active · expires Mar 22, 2027
CLIA Number34D2278768
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorErica Savage-Jeter
Laboratory Phone(919) 578-3974
Laboratory LocationCenterwell Senior Primary Care-Roxboro3500 N. Roxboro St. Suite 1B, Durham, NC 27704
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 2

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

MARIA PAOLA SANTOS MD
Family Medicine
3500 N ROXBORO ST STE 1B
DURHAM, NC 27704
Durham County (919) 578-3974
KAVITHAMANI MALLAN FNP
Nurse Practitioner (Family)
3500 N ROXBORO ST STE 1B
DURHAM, NC 27704
Durham County (919) 578-3974

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 Nc Jv PC's NPI number?

The NPI number for Centerwell Senior Primary Care Nc Jv PC is 1114623386. It was assigned to this organization in the NPPES registry on January 31, 2023. The provider is doing business as Centerwell Senior Primary Care-Roxboro.

Where is Centerwell Senior Primary Care Nc Jv PC located?

Centerwell Senior Primary Care Nc Jv PC is located at 3500 N Roxboro St Ste 1B, Durham, NC 27704. The listed phone number is (919) 578-3974.

What is Centerwell Senior Primary Care Nc Jv PC's specialty?

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

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

Yes. A Certificate of Waiver (number 34D2278768) is associated with this NPI, valid through March 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Centerwell Senior Primary Care Nc Jv PC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Centerwell Senior Primary Care Nc Jv PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Nc Jv PC was last updated on August 11, 2023. 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.