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CENTERWELL SENIOR PRIMARY CARE-COLLEGE PARK
NPI 1396511648
Internal Medicine in Indianapolis, IN

Active since November 28, 2023CLIA 15D2304300 · Waiver
2902 W 86TH ST, INDIANAPOLIS, IN 46268(407) 447-7120 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Centerwell Senior Primary Care-college Park NPPES

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

CENTERWELL SENIOR PRIMARY CARE-COLLEGE PARK (NPI 1396511648) is a healthcare organization registered as an internal medicine in Indianapolis, Indiana and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through May 9, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1396511648
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE IN PC
Location Address2902 W 86TH STIndianapolis, IN 46268-5900
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(407) 447-7120
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateNovember 28, 2023
Last NPPES UpdateJuly 1, 2024
NPPES CertifiedJuly 1, 2024
✔ NPI 1396511648 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
2902 W 86TH ST, Indianapolis, IN 46268
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-college Park

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 15D2304300

Centerwell Senior Primary Care-College Park · Indianapolis, IN
Active · expires May 9, 2028
CLIA Number15D2304300
Laboratory TypePhysician Office
Certificate Effective DateMay 10, 2026
Certificate Expiration DateMay 9, 2028
Laboratory DirectorErica Savage-Jeter
Laboratory Phone(317) 343-8607
Laboratory LocationCenterwell Senior Primary Care-College Park2902 W 86th Street Suite 220, Indianapolis, IN 46268
CLIA data matches this NPI record on: Address Name
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.

STEPHANIE WOOD O.T.R.
Occupational Therapist (Driving and Community Mobility)
2902 W 86TH ST, SUITE 160
INDIANAPOLIS, IN 46268
Marion County (317) 228-9163
VISION REHABILITATIVE SERVICES, INC.
Occupational Therapist
2902 W 86TH ST, SUITE 160
INDIANAPOLIS, IN 46268
Marion County (317) 228-9163
OSSIP OPTOMETRY PC
Optometrist
2902 W 86TH ST, STE 160
INDIANAPOLIS, IN 46268
Marion County (317) 337-1233

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 In PC's NPI number?

The NPI number for Centerwell Senior Primary Care In PC is 1396511648. It was assigned to this organization in the NPPES registry on November 28, 2023. The provider is doing business as Centerwell Senior Primary Care-College Park.

Where is Centerwell Senior Primary Care In PC located?

Centerwell Senior Primary Care In PC is located at 2902 W 86th St, Indianapolis, IN 46268. The listed phone number is (407) 447-7120.

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

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

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

Yes. A Certificate of Waiver (number 15D2304300) is associated with this NPI, valid through May 9, 2028. 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 In PC was last updated on July 1, 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.