CENTERWELL SENIOR PRIMARY CARE-JACKSON EAST
NPI 1710693619
Internal Medicine in Jackson, MS
NPI Status: Active since January 25, 2023
Contact Information
1220 E NORTHSIDE DR STE 220
JACKSON, MS
ZIP 39211
Phone: (601) 298-4173
Fax: (877) 866-2356
- Organization
- Internal Medicine
- CLIA Number: 25D2278595
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-20-2027
About CENTERWELL SENIOR PRIMARY CARE-JACKSON EAST
This page provides the complete NPI Profile along with additional information for Centerwell Senior Primary Care-jackson East, an internist established in Jackson, Mississippi operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1710693619 assigned on January 2023. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Centerwell Senior Primary Care-jackson East operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Centerwell Senior Primary Care-jackson East. The authorized official of this NPI record is Angie Martinez (Senior Credentialing Professional)
- NPI
- 1710693619
- Provider Legal Name
- CENTERWELL SENIOR PRIMARY CARE MS PC
- Other Organization Name
- CENTERWELL SENIOR PRIMARY CARE-JACKSON EAST
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1220 E NORTHSIDE DR STE 220 JACKSON, MS 39211
- Location Phone
- (601) 298-4173
- Location Fax
- (877) 866-2356
- Mailing Address
- 6101 BLUE LAGOON DR STE 200 MIAMI, FL 33126
- Mailing Phone
- (305) 500-2000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 01-25-2023
- Last Update Date
- 07-03-2024
- Code Navigator
An internist like Centerwell Senior Primary Care-jackson East is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D2278595
- Facility Type
- Physician Office
- Certificate Effective Date
- March 21, 2025
- Certificate Expiration Date
- March 20, 2027
- Laboratory Director
- DR. EARL K. MAGEE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Centerwell Senior Primary Care-jackson East to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710693619, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710693619, enumerated as an "organization" on January 25, 2023.
The provider is located at 1220 E NORTHSIDE DR STE 220 JACKSON, MS 39211 and the phone number is (601) 298-4173.
Internal Medicine with taxonomy code 207R00000X.
