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CENTERWELL SENIOR PRIMARY CARE GA PC
NPI 1154148526
Internal Medicine in Suwanee, GA

Active since September 25, 2024CLIA 11D2319990 · Waiver
3245 LAWRENCEVILLE SUWANEE RD # 100, SUWANEE, GA 30024(770) 341-9135(770) 545-6599 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Dec 17, 2024, Sep 25, 2024 (2 updates tracked since 2024).

About Centerwell Senior Primary Care Ga Pc NPPES

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

CENTERWELL SENIOR PRIMARY CARE GA PC (NPI 1154148526), doing business as Centerwell Senior Primary Care-suwanee, is a healthcare organization registered as an internal medicine in Suwanee, Georgia and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1154148526
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE GA PC
Location Address3245 LAWRENCEVILLE SUWANEE RD # 100Suwanee, GA 30024-6541
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120 · Fax (407) 770-0661
Phone(770) 341-9135
Fax(770) 545-6599
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateSeptember 25, 2024
Last NPPES UpdateJanuary 24, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2025
✔ NPI 1154148526 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 ListedGeneral PracticeTaxonomy 208D00000X
Also ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X
3245 LAWRENCEVILLE SUWANEE RD # 100, Suwanee, GA 30024
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Other Names 1

Doing Business AsCenterwell Senior Primary Care-suwanee

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 11D2319990

Centerwell Senior Primary Care (ga) Pc-Suwanee · Suwanee, GA
Active · expires Mar 10, 2027
CLIA Number11D2319990
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorDr. Jarvis J. Sanchez Rivera
Laboratory Phone(770) 341-9135
Laboratory LocationCenterwell Senior Primary Care (ga) Pc-Suwanee3245 Lawrenceville Suwanee Road #100, Suwanee, GA 30024
CLIA data matches this NPI record on: 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 1154148526. It was assigned to this organization in the NPPES registry on September 25, 2024. The provider is doing business as CenterWell Senior Primary Care-Suwanee.

Where is Centerwell Senior Primary Care Ga PC located?

Centerwell Senior Primary Care Ga PC is located at 3245 Lawrenceville Suwanee Rd # 100, Suwanee, GA 30024. The listed phone number is (770) 341-9135.

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 11D2319990) is associated with this NPI, valid through March 10, 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 Ga PC was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.