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CENTERWELL SENIOR PRIMARY CARE-WEST CRAIG
NPI 1255954640
Internal Medicine in Las Vegas, NV

Active since May 20, 2020CLIA Certified · 2 labs
4919 W CRAIG RD, LAS VEGAS, NV 89130(725) 220-8706(833) 749-0366 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 3, 2024, Oct 20, 2022, Apr 9, 2021 and 4 more (7 updates tracked since 2020).

About Centerwell Senior Primary Care-west Craig NPPES

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

CENTERWELL SENIOR PRIMARY CARE-WEST CRAIG (NPI 1255954640) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since May 2020. The organization holds 2 active CLIA laboratory certificates and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1255954640
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address4919 W CRAIG RDLas Vegas, NV 89130-2730
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(725) 220-8706
Fax(833) 749-0366
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateMay 20, 2020
Last NPPES UpdateJuly 3, 20247 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
✔ NPI 1255954640 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
4919 W CRAIG RD, Las Vegas, NV 89130
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Other Names 2

Doing Business AsCenterwell Senior Primary Care-west Craig
Former Legal Business NamePartners In Primary Care (nv) Pc

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 2

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 29D2212571

Centerwell Senior Primary Care- West Craig · Las Vegas, NV
Active · expires Feb 3, 2027
CLIA Number29D2212571
Laboratory TypePhysician Office
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorTracy Wakefield
Laboratory Phone(725) 220-8706
Laboratory LocationCenterwell Senior Primary Care- West Craig4919 W Craig Rd, Las Vegas, NV 89130
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 29D2199174

Centerwell Senior Primary Care - South Eastern · Las Vegas, NV
Active · expires Nov 4, 2026
CLIA Number29D2199174
Laboratory TypePhysician Office
Certificate Effective DateNovember 5, 2024
Certificate Expiration DateNovember 4, 2026
Laboratory DirectorTracy Wakefield
Laboratory Phone(725) 220-8706
Laboratory LocationCenterwell Senior Primary Care - South Eastern4813 S Eastern Ave, Las Vegas, NV 89119
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

CHERIELYNN S WAGNER DO
Family Medicine
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
KARYN HARRIES DO
Family Medicine
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
HAZEL TAN FELIX NURSE PRACTITIONER
Nurse Practitioner (Family)
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
DR. REBECCA J O'ROURKE M.D.
Family Medicine
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
DR. KASEY LAZ ABANONU JR. MD
Internal Medicine
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
DOROTHY MAY DESIERTO AGDAMAG APRN
Nurse Practitioner
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706
GREGORY DESIMONE DO
Family Medicine
4919 W CRAIG RD
LAS VEGAS, NV 89130
Clark County (725) 220-8706

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 (nv) PC's NPI number?

The NPI number for Centerwell Senior Primary Care (nv) PC is 1255954640. It was assigned to this organization in the NPPES registry on May 20, 2020. The provider is doing business as Centerwell Senior Primary Care-West Craig. The provider was formerly known as Partners in Primary Care (NV) PC.

Where is Centerwell Senior Primary Care (nv) PC located?

Centerwell Senior Primary Care (nv) PC is located at 4919 W Craig Rd, Las Vegas, NV 89130. The listed phone number is (725) 220-8706.

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

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

Does Centerwell Senior Primary Care (nv) PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care (nv) PC was last updated on July 3, 2024. 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.