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CENTERWELL SENIOR PRIMARY CARE- DIXIE HIGHWAY
NPI 1699549683
Internal Medicine in Louisville, KY

Active since November 09, 2023CLIA 18D2303650 · Waiver
4917 DIXIE HWY STE E, LOUISVILLE, KY 40216(407) 447-7120(877) 243-0175 Get Directions Write a Review

NPPES record last updated: August 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 22, 2024, Nov 9, 2023 (2 updates tracked since 2023).

About Centerwell Senior Primary Care- Dixie Highway NPPES

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

CENTERWELL SENIOR PRIMARY CARE- DIXIE HIGHWAY (NPI 1699549683) is a healthcare organization registered as an internal medicine in Louisville, Kentucky and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through April 28, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1699549683
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (KY) PSC
Location Address4917 DIXIE HWY STE ELouisville, KY 40216-2565
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(407) 447-7120
Fax(877) 243-0175
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateNovember 9, 2023
Last NPPES UpdateAugust 22, 20242 updates tracked since enumeration
NPPES CertifiedAugust 22, 2024
✔ NPI 1699549683 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
4917 DIXIE HWY STE E, Louisville, KY 40216
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care- Dixie Highway

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 18D2303650

Centerwell Senior Primary Care-Dixie Highway -Dixie Highway · Louisville, KY
Active · expires Apr 28, 2028
CLIA Number18D2303650
Laboratory TypePhysician Office
Certificate Effective DateApril 29, 2026
Certificate Expiration DateApril 28, 2028
Laboratory DirectorDr. Erica L. Savage-Jeter
Laboratory Phone(502) 414-5043
Laboratory LocationCenterwell Senior Primary Care-Dixie Highway -Dixie Highway4917 Dixie Highway Suite E, Louisville, KY 40216
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.

PUSHPA PAVULURI M.D.
Internal Medicine
4917 DIXIE HWY STE E
LOUISVILLE, KY 40216
Jefferson County (502) 414-5043
DR. CYNTHIA COX MAHIN M.D.
Family Medicine
4917 DIXIE HWY STE E
LOUISVILLE, KY 40216
Jefferson County (502) 414-5043
SHELBY R ROMINE APRN
Nurse Practitioner (Family)
4917 DIXIE HWY STE E
LOUISVILLE, KY 40216
Jefferson County (502) 242-7559

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 (ky) Psc's NPI number?

The NPI number for Centerwell Senior Primary Care (ky) Psc is 1699549683. It was assigned to this organization in the NPPES registry on November 9, 2023. The provider is doing business as Centerwell Senior Primary Care- Dixie Highway.

Where is Centerwell Senior Primary Care (ky) Psc located?

Centerwell Senior Primary Care (ky) Psc is located at 4917 Dixie Hwy Ste E, Louisville, KY 40216. The listed phone number is (407) 447-7120.

What is Centerwell Senior Primary Care (ky) Psc's specialty?

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

Does Centerwell Senior Primary Care (ky) Psc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2303650) is associated with this NPI, valid through April 28, 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 (ky) Psc was last updated on August 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.