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CENTERWELL SENIOR PRIMARY CARE-SOUTH NELLIS
NPI 1306469788
Internal Medicine in Las Vegas, NV

Active since May 20, 2020CLIA 29D2197195 · Waiver
2875 S NELLIS BLVD STE 3, LAS VEGAS, NV 89121(702) 843-2420(833) 749-0351 Get Directions Write a Review

NPPES record last updated: February 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 20, 2022, Apr 9, 2021, Feb 23, 2021 and 2 more (5 updates tracked since 2020).

About Centerwell Senior Primary Care-south Nellis NPPES

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

CENTERWELL SENIOR PRIMARY CARE-SOUTH NELLIS (NPI 1306469788) 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 a CLIA Waiver certificate valid through October 21, 2026 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1306469788
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address2875 S NELLIS BLVD STE 3Las Vegas, NV 89121-2087
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Phone(702) 843-2420
Fax(833) 749-0351
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateMay 20, 2020
Last NPPES UpdateFebruary 15, 20245 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2024
✔ NPI 1306469788 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
2875 S NELLIS BLVD STE 3, Las Vegas, NV 89121
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Other Names 2

Doing Business AsCenterwell Senior Primary Care-south Nellis
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

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 29D2197195

Centerwell Senior Primary Care - South Nellis · Las Vegas, NV
Active · expires Oct 21, 2026
CLIA Number29D2197195
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorTracy Wakefield
Laboratory Phone(702) 843-2420
Laboratory LocationCenterwell Senior Primary Care - South Nellis2875 S Nellis Blvd Ste 3, Las Vegas, NV 89121
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 10

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

TRACY J WAKEFIELD MD
Internal Medicine
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
FLOR ELENA GUERRERO APRN
Nurse Practitioner (Family)
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
MARITESS NABONG APRN
Nurse Practitioner (Family)
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
NINA V NATION PA-C
Physician Assistant
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
RAMIN ETEBAR MD LTD
Internal Medicine
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
HAYLEY KUHN MD
Family Medicine
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
ITHA DALRYMPLE D.O.
Family Medicine
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420
STEPHEN LYNN
Family Medicine
2875 S NELLIS BLVD STE 3
LAS VEGAS, NV 89121
Clark County (702) 843-2420

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 1306469788. It was assigned to this organization in the NPPES registry on May 20, 2020. The provider is doing business as Centerwell Senior Primary Care-South Nellis. 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 2875 S Nellis Blvd Ste 3, Las Vegas, NV 89121. The listed phone number is (702) 843-2420.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 29D2197195) is associated with this NPI, valid through October 21, 2026. 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 (nv) PC was last updated on February 15, 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.