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CENTERWELL SENIOR PRIMARY CARE- CAMP BOWIE WEST
NPI 1518696673
Internal Medicine in Fort Worth, TX

Active since June 06, 2022CLIA 45D2264993 · Waiver
9108 CAMP BOWIE WEST BLVD, FORT WORTH, TX 76116(682) 990-6492(877) 688-9560 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Oct 18, 2022, Jun 6, 2022 (2 updates tracked since 2022).

About Centerwell Senior Primary Care- Camp Bowie West NPPES

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

CENTERWELL SENIOR PRIMARY CARE- CAMP BOWIE WEST (NPI 1518696673) is a healthcare organization registered as an internal medicine in Fort Worth, Texas and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through July 20, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1518696673
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (TX) PA
Location Address9108 CAMP BOWIE WEST BLVDFort Worth, TX 76116-6098
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120
Phone(682) 990-6492
Fax(877) 688-9560
Organization SubpartYesParent: Centerwell Senior Primary Care Tx Pa
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJune 6, 2022
Last NPPES UpdateOctober 18, 20222 updates tracked since enumeration
NPPES CertifiedOctober 18, 2022
✔ NPI 1518696673 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
9108 CAMP BOWIE WEST BLVD, Fort Worth, TX 76116
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Other Names 1

Doing Business AsCenterwell Senior Primary Care- Camp Bowie West

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 45D2264993

Centerwell Senior Primary Care - Camp Bowie West · Fort Worth, TX
Active · expires Jul 20, 2028
CLIA Number45D2264993
Laboratory TypePhysician Office
Certificate Effective DateJuly 21, 2026
Certificate Expiration DateJuly 20, 2028
Laboratory DirectorAn Thein Tang
Laboratory Phone(682) 990-6492
Laboratory LocationCenterwell Senior Primary Care - Camp Bowie West9108 Camp Bowie West Blvd., Fort Worth, TX 76116
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 2

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

DR. MICHAEL R TODD M.D.
Internal Medicine (Geriatric Medicine)
9108 CAMP BOWIE WEST BLVD
FT WORTH, TX 76116
Tarrant County (682) 990-6492
MELISSA ELIZABETH SMITH FNP
Nurse Practitioner (Family)
9108 CAMP BOWIE WEST BLVD
FORT WORTH, TX 76116
Tarrant County (682) 356-2273

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 (tx) PA's NPI number?

The NPI number for Centerwell Senior Primary Care (tx) PA is 1518696673. It was assigned to this organization in the NPPES registry on June 6, 2022. The provider is doing business as Centerwell Senior Primary Care- Camp Bowie West.

Where is Centerwell Senior Primary Care (tx) PA located?

Centerwell Senior Primary Care (tx) PA is located at 9108 Camp Bowie West Blvd, Fort Worth, TX 76116. The listed phone number is (682) 990-6492.

What is Centerwell Senior Primary Care (tx) PA's specialty?

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

Does Centerwell Senior Primary Care (tx) PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2264993) is associated with this NPI, valid through July 20, 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 (tx) PA was last updated on October 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.