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CENTERWELL SENIOR PRIMARY CARE- DENHAM SPRINGS
NPI 1336721620
Internal Medicine in Denham Springs, LA

Active since April 26, 2021CLIA 19D2236863 · Waiver
2314 S RANGE AVE, DENHAM SPRINGS, LA 70726(225) 480-4080(877) 485-4275 Get Directions Write a Review

NPPES record last updated: August 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 22, 2024, Nov 7, 2022, Sep 13, 2021 and 1 more (4 updates tracked since 2021).

About Centerwell Senior Primary Care- Denham Springs NPPES

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

CENTERWELL SENIOR PRIMARY CARE- DENHAM SPRINGS (NPI 1336721620) is a healthcare organization registered as an internal medicine in Denham Springs, Louisiana and active in the NPI registry since April 2021. The organization holds a CLIA Waiver certificate valid through September 20, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1336721620
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE LA PC
Location Address2314 S RANGE AVEDenham Springs, LA 70726-5216
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(225) 480-4080
Fax(877) 485-4275
Organization SubpartNo
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateApril 26, 2021
Last NPPES UpdateAugust 22, 20244 updates tracked since enumeration
NPPES CertifiedAugust 22, 2024
✔ NPI 1336721620 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
2314 S RANGE AVE, Denham Springs, LA 70726
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care- Denham Springs

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 19D2236863

Centerwell Senior Primary Care - Denham Springs · Denham Springs, LA
Active · expires Sep 20, 2027
CLIA Number19D2236863
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2025
Certificate Expiration DateSeptember 20, 2027
Laboratory DirectorEarl Magee
Laboratory Phone(225) 480-4080
Laboratory LocationCenterwell Senior Primary Care - Denham Springs2314 S Range Ave, Denham Springs, LA 70726
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 3

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

DR. GORDON H CLARK MD
Family Medicine
2314 S RANGE AVE
DENHAM SPRINGS, LA 70726
Livingston Parish (225) 480-4080
DR. KERRY EUGENE SHAVER M.D.
Internal Medicine
2314 S RANGE AVE
DENHAM SPRINGS, LA 70726
Livingston Parish (225) 480-4080
MRS. ADRAVON S HENDERSON FNP
Nurse Practitioner (Family)
2314 S RANGE AVE
DENHAM SPRINGS, LA 70726
Livingston Parish (225) 480-4080

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 La PC's NPI number?

The NPI number for Centerwell Senior Primary Care La PC is 1336721620. It was assigned to this organization in the NPPES registry on April 26, 2021. The provider is doing business as Centerwell Senior Primary Care- Denham Springs.

Where is Centerwell Senior Primary Care La PC located?

Centerwell Senior Primary Care La PC is located at 2314 S Range Ave, Denham Springs, LA 70726. The listed phone number is (225) 480-4080.

What is Centerwell Senior Primary Care La PC's specialty?

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

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

Yes. A Certificate of Waiver (number 19D2236863) is associated with this NPI, valid through September 20, 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 La PC was last updated on August 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.