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CENTERWELL SENIOR PRIMARY CARE-LEBANON
NPI 1386358828
Internal Medicine in Lebanon, TN

Active since January 10, 2023CLIA 44D2280284 · Waiver
1436 W MAIN ST, LEBANON, TN 37087(615) 965-6108 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 3, 2024, Jan 10, 2023 (2 updates tracked since 2023).

About Centerwell Senior Primary Care-lebanon NPPES

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

CENTERWELL SENIOR PRIMARY CARE-LEBANON (NPI 1386358828) is a healthcare organization registered as an internal medicine in Lebanon, Tennessee and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through April 16, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1386358828
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE TN PC
Location Address1436 W MAIN STLebanon, TN 37087-1323
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(615) 965-6108
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJanuary 10, 2023
Last NPPES UpdateJuly 3, 20242 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
✔ NPI 1386358828 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
1436 W MAIN ST, Lebanon, TN 37087
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-lebanon

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 44D2280284

Centerwell Senior Primary Care-Lebanon · Lebanon, TN
Active · expires Apr 16, 2027
CLIA Number44D2280284
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2025
Certificate Expiration DateApril 16, 2027
Laboratory DirectorDr. Erica L. Savage-Jeter
Laboratory Phone(615) 965-6108
Laboratory LocationCenterwell Senior Primary Care-Lebanon1436 W Main Street, Lebanon, TN 37087
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 4

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

DR. DONALD O. EZUTEH M.D.
Internal Medicine
1436 W MAIN ST
LEBANON, TN 37087
Wilson County (615) 965-6108
MARCIA LYNN TAPIA ANP-BC
Nurse Practitioner (Adult Health)
1436 W MAIN ST
LEBANON, TN 37087
Wilson County (615) 965-6108
OVIDIU GHITA D.O.
Internal Medicine
1436 W MAIN ST
LEBANON, TN 37087
Wilson County (615) 965-6108
MRS. ASHLIE SLOAN
Nurse Practitioner (Family)
1436 W MAIN ST
LEBANON, TN 37087
Wilson County (615) 965-6108

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 Tn PC's NPI number?

The NPI number for Centerwell Senior Primary Care Tn PC is 1386358828. It was assigned to this organization in the NPPES registry on January 10, 2023. The provider is doing business as Centerwell Senior Primary Care-Lebanon.

Where is Centerwell Senior Primary Care Tn PC located?

Centerwell Senior Primary Care Tn PC is located at 1436 W Main St, Lebanon, TN 37087. The listed phone number is (615) 965-6108.

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

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

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

Yes. A Certificate of Waiver (number 44D2280284) is associated with this NPI, valid through April 16, 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 Tn PC was last updated on July 3, 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.