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CENTERWELL SENIOR PRIMARY CARE-MARIETTA
NPI 1487471389
Internal Medicine in Marietta, GA

Active since September 23, 2024CLIA 11D2319988 · Waiver
210 COBB PKWY S # 100, MARIETTA, GA 30060(678) 941-6245(678) 809-5228 Get Directions Write a Review

NPPES record last updated: December 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2024, Sep 23, 2024 (2 updates tracked since 2024).

About Centerwell Senior Primary Care-marietta NPPES

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

CENTERWELL SENIOR PRIMARY CARE-MARIETTA (NPI 1487471389) is a healthcare organization registered as an internal medicine in Marietta, Georgia and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1487471389
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE GA PC
Location Address210 COBB PKWY S # 100Marietta, GA 30060-6509
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120 · Fax (407) 770-0661
Phone(678) 941-6245
Fax(678) 809-5228
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateSeptember 23, 2024
Last NPPES UpdateDecember 17, 20242 updates tracked since enumeration
NPPES CertifiedDecember 17, 2024
✔ NPI 1487471389 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
210 COBB PKWY S # 100, Marietta, GA 30060
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-marietta

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 11D2319988

Centerwell Senior Primary Care (ga) Pc-Marietta · Marietta, GA
Active · expires Mar 10, 2027
CLIA Number11D2319988
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorDr. Alexis M. Atwater
Laboratory Phone(678) 941-6245
Laboratory LocationCenterwell Senior Primary Care (ga) Pc-Marietta210 Cobb Parkway S #100, Marietta, GA 30060
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

FABIANE APOLINARIO SENCION FNP-BC
Nurse Practitioner (Family)
210 COBB PKWY S # 100
MARIETTA, GA 30060
Cobb County (678) 941-2186

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 Ga PC's NPI number?

The NPI number for Centerwell Senior Primary Care Ga PC is 1487471389. It was assigned to this organization in the NPPES registry on September 23, 2024. The provider is doing business as Centerwell Senior Primary Care-Marietta.

Where is Centerwell Senior Primary Care Ga PC located?

Centerwell Senior Primary Care Ga PC is located at 210 Cobb Pkwy S # 100, Marietta, GA 30060. The listed phone number is (678) 941-6245.

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

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

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

Yes. A Certificate of Waiver (number 11D2319988) is associated with this NPI, valid through March 10, 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 Ga PC was last updated on December 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.