CENTERWELL SENIOR PRIMARY CARE-MARIETTA
NPI 1487471389
Internal Medicine in Marietta, GA
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
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Centerwell Senior Primary Care-marietta is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
67Medicare enrollment records show 67 clinicians reassign Medicare billing to Centerwell Senior Primary Care-Marietta, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 67Atlanta, GA 30311
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, GAFrequently 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.
Is Centerwell Senior Primary Care Ga PC enrolled in Medicare?
Yes. Centerwell Senior Primary Care Ga PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Centerwell Senior Primary Care Ga PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 67 clinicians in 5 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care Ga PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (28), Internal Medicine (16) and Family Practice (13). Of these, 1 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 22 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.
# Centerwell Senior Primary Care-Marietta · NPI 1487471389
Internal Medicine organization in Marietta, Georgia. Organization record, active in the CMS NPPES registry since September 23, 2024.
## Identity
- **NPI:** 1487471389 (Entity type: Organization)
- **Enumerated:** September 23, 2024
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Centerwell Senior Primary Care Ga Pc
- **Organization subpart:** Yes (part of Centerwell Senior Primary Care Ga Pc)
- **Authorized official:** Angie Martinez, SENIOR CREDENTIALING PROFESSIONAL
## Practice location
- **Address:** 210 COBB PKWY S # 100, Marietta, GA 30060-6509
- **Phone:** (678) 941-6245 · **Fax:** (678) 809-5228
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 67 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (28), Internal Medicine (16), Family Practice (13); 1 practice at this address and 9 within 10 miles; [full list](https://npiprofile.com/npi/1487471389/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 17, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487471389) · Data from the CMS NPPES public registry.