1. Home
  2. Directory
  3. South Carolina
  4. Myrtle Beach
  5. Internal Medicine
  6. NPI Profile

CENTERWELL SENIOR PRIMARY CARE-CAROLINA FOREST
NPI 1376242917
Internal Medicine in Myrtle Beach, SC

Active since March 02, 2023CLIA 42D2281258 · Waiver
3725 RENEE DR, MYRTLE BEACH, SC 29579(843) 350-1124(877) 452-8854 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

About Centerwell Senior Primary Care-carolina Forest NPPES

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

CENTERWELL SENIOR PRIMARY CARE-CAROLINA FOREST (NPI 1376242917) is a healthcare organization registered as an internal medicine in Myrtle Beach, 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

NPI1376242917
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE SC JV PC
Location Address3725 RENEE DRMyrtle Beach, SC 29579-4109
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(843) 350-1124
Fax(877) 452-8854
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 1376242917 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
3725 RENEE DR, Myrtle Beach, SC 29579
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-carolina Forest

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 42D2281258

Centerwell Senior Primary Care-Carolina Forest · Myrtle Beach, SC
Active · expires May 3, 2027
CLIA Number42D2281258
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorDr. Erica Savage-Jeter
Laboratory Phone(843) 350-1124
Laboratory LocationCenterwell Senior Primary Care-Carolina Forest3725 Renee Drive, Myrtle Beach, SC 29579
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.

MRS. JESSICA LEIGH IONNO NP
Nurse Practitioner (Family)
3725 RENEE DR
MYRTLE BEACH, SC 29579
Horry County (843) 350-1124
VALDA GIBSON M.D.
Internal Medicine
3725 RENEE DR
MYRTLE BEACH, SC 29579
Horry County (843) 350-1124
ALEXIS JO BROWN MD
Family Medicine
3725 RENEE DR
MYRTLE BEACH, SC 29579
Horry County (843) 350-1124

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 1376242917. It was assigned to this organization in the NPPES registry on March 2, 2023. The provider is doing business as Centerwell Senior Primary Care-Carolina Forest.

Where is Centerwell Senior Primary Care Sc Jv PC located?

Centerwell Senior Primary Care Sc Jv PC is located at 3725 Renee Dr, Myrtle Beach, SC 29579. The listed phone number is (843) 350-1124.

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 42D2281258) 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 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.