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CENTRO MEDICO SAN ANTONIO LLC
NPI 1346972858
Family Medicine in Norcross, GA

Active since June 24, 2022
5139 JIMMY CARTER BLVD STE 203, NORCROSS, GA 30093(770) 885-9684 Get Directions Write a Review

NPPES record last updated: July 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Centro Medico San Antonio Llc NPPES

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

CENTRO MEDICO SAN ANTONIO LLC (NPI 1346972858) is a healthcare organization registered as a family medicine in Norcross, Georgia and active in the NPI registry since June 2022. The organization lists Nancy Reyes, Manager, as its authorized official.

NPPES Registry Identity

NPI1346972858
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCENTRO MEDICO SAN ANTONIO LLC
Location Address5139 JIMMY CARTER BLVD STE 203Norcross, GA 30093-1638
Mailing Address5139 Jimmy Carter Blvd Ste 203Norcross, GA 30093-1638 · (770) 885-9684
Phone(770) 885-9684
Organization SubpartNo
Authorized OfficialNancy ReyesManager · (770) 885-9684
Enumeration DateJune 24, 2022
Last NPPES UpdateJuly 6, 2022
NPPES CertifiedJuly 6, 2022
✔ NPI 1346972858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5139 JIMMY CARTER BLVD STE 203, Norcross, GA 30093
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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 11D2265740

Centro Medico San Antonio · Norcross, GA
Expired · Aug 1, 2026
CLIA Number11D2265740
Laboratory TypePhysician Office
Certificate Effective DateAugust 2, 2024
Certificate Expiration DateAugust 1, 2026
Laboratory DirectorJean Philippe-Damberville
Laboratory Phone(770) 885-9684
Laboratory LocationCentro Medico San Antonio5139 Jimmy Carter Boulevard, Suite 203, Norcross, GA 30093
CLIA data matches this NPI record on: Address 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 Centro Medico San Antonio LLC's NPI number?

The NPI number for Centro Medico San Antonio LLC is 1346972858. It was assigned to this organization in the NPPES registry on June 24, 2022.

Where is Centro Medico San Antonio LLC located?

Centro Medico San Antonio LLC is located at 5139 Jimmy Carter Blvd Ste 203, Norcross, GA 30093. The listed phone number is (770) 885-9684.

What is Centro Medico San Antonio LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Centro Medico San Antonio LLC was last updated on July 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.