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CENTERWELL SENIOR PRIMARY CARE NC JV PC
NPI 1255045795
Internal Medicine in Raleigh, NC

Active since January 10, 2023CLIA 34D2278770 · Waiver
1408 GARNER STATION BLVD, RALEIGH, NC 27603(984) 283-1720 Get Directions Write a Review

NPPES record last updated: January 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Centerwell Senior Primary Care Nc Jv Pc NPPES

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

CENTERWELL SENIOR PRIMARY CARE NC JV PC (NPI 1255045795), doing business as Centerwell Senior Primary Care- Garner Station, is a healthcare organization registered as an internal medicine in Raleigh, 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

NPI1255045795
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE NC JV PC
Location Address1408 GARNER STATION BLVDRaleigh, NC 27603-3600
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120
Phone(984) 283-1720
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJanuary 10, 2023
NPPES CertifiedJanuary 10, 2023
✔ NPI 1255045795 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
1408 GARNER STATION BLVD, Raleigh, NC 27603
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Other Names 1

Doing Business AsCenterwell Senior Primary Care- Garner Station

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 34D2278770

Centerwell Senior Primary Care-Garner Station · Raleigh, NC
Active · expires Mar 22, 2027
CLIA Number34D2278770
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorErica Savage-Jeter
Laboratory Phone(984) 283-1720
Laboratory LocationCenterwell Senior Primary Care-Garner Station1408 Garner Station Blvd., Raleigh, NC 27603
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 4

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

DAMARIS WANJIKU GICHUHI
Nurse Practitioner (Adult Health)
1408 GARNER STATION BLVD
RALEIGH, NC 27603
Wake County (984) 283-1720
DR. ROSMY JIMMY MD
Internal Medicine
1408 GARNER STATION BLVD
RALEIGH, NC 27603
Wake County (984) 283-1722
DR. FATHIMA FARAH NAUSHAD MD
Family Medicine
1408 GARNER STATION BLVD
RALEIGH, NC 27603
Wake County (984) 283-1722
DORRIE EDGESTON-JONES DNP, FNP
Nurse Practitioner (Family)
1408 GARNER STATION BLVD
RALEIGH, NC 27603
Wake County (984) 283-1720

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 1255045795. It was assigned to this organization in the NPPES registry on January 10, 2023. The provider is doing business as CenterWell Senior Primary Care- Garner Station.

Where is Centerwell Senior Primary Care Nc Jv PC located?

Centerwell Senior Primary Care Nc Jv PC is located at 1408 Garner Station Blvd, Raleigh, NC 27603. The listed phone number is (984) 283-1720.

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 34D2278770) is associated with this NPI, valid through March 22, 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 Nc Jv PC was last updated on January 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.