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CENTERWELL SENIOR PRIMARY CARE-DECKER BLVD
NPI 1356040992
Internal Medicine in Columbia, SC

Active since March 02, 2023CLIA 42D2281256 · Waiver
2738 DECKER BLVD STE A, COLUMBIA, SC 29206(803) 969-0543(877) 958-9029 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2024, Aug 11, 2023, Mar 2, 2023 (3 updates tracked since 2023).

About Centerwell Senior Primary Care-decker Blvd NPPES

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

CENTERWELL SENIOR PRIMARY CARE-DECKER BLVD (NPI 1356040992) is a healthcare organization registered as an internal medicine in Columbia, South Carolina and active in the NPI registry since March 2023. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1356040992
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE SC JV PC
Location Address2738 DECKER BLVD STE AColumbia, SC 29206-1735
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(803) 969-0543
Fax(877) 958-9029
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateMarch 2, 2023
Last NPPES UpdateAugust 19, 20243 updates tracked since enumeration
NPPES CertifiedAugust 19, 2024
✔ NPI 1356040992 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
2738 DECKER BLVD STE A, Columbia, SC 29206
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-decker Blvd

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 42D2281256

Centerwell Senior Primary Care-Decker Blvd · Columbia, SC
Active · expires May 3, 2027
CLIA Number42D2281256
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorDr. Erica Savage-Jeter
Laboratory Phone(803) 969-0543
Laboratory LocationCenterwell Senior Primary Care-Decker Blvd2738 Decker Blvd, Suite A, Columbia, SC 29206
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 2

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

AMIT R PITALIA MD
Family Medicine
2738 DECKER BLVD STE A
COLUMBIA, SC 29206
Richland County (803) 969-0543
DR. UDAY DOPPALAPUDI M.D.
Internal Medicine
2738 DECKER BLVD STE A
COLUMBIA, SC 29206
Richland County (803) 969-0543

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 Sc Jv PC's NPI number?

The NPI number for Centerwell Senior Primary Care Sc Jv PC is 1356040992. It was assigned to this organization in the NPPES registry on March 2, 2023. The provider is doing business as Centerwell Senior Primary Care-Decker Blvd.

Where is Centerwell Senior Primary Care Sc Jv PC located?

Centerwell Senior Primary Care Sc Jv PC is located at 2738 Decker Blvd Ste A, Columbia, SC 29206. The listed phone number is (803) 969-0543.

What is Centerwell Senior Primary Care Sc Jv PC's specialty?

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

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

Yes. A Certificate of Waiver (number 42D2281256) is associated with this NPI, valid through May 3, 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 Sc Jv PC was last updated on August 19, 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.