CENTERWELL SENIOR PRIMARY CARE- EASTSIDE
NPI 1780455527
Internal Medicine in Frankfort, KY

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

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

Active since January 10, 2024CLIA 18D0958340 · Waiver

601 VERSAILLES RD, FRANKFORT, KY 40601(502) 695-3946 Get Directions Write a Review

NPPES record last updated: August 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Centerwell Senior Primary Care- Eastside NPPES

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

CENTERWELL SENIOR PRIMARY CARE- EASTSIDE (NPI 1780455527) is a healthcare organization registered as an internal medicine in Frankfort, Kentucky and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through September 13, 2026 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1780455527

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCENTERWELL SENIOR PRIMARY CARE (KY) PSC

Location Address601 VERSAILLES RDFrankfort, KY 40601-3857

Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000

Phone(502) 695-3946

Organization SubpartYes

Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120

Enumeration DateJanuary 10, 2024

Last NPPES UpdateAugust 22, 2024

NPPES CertifiedAugust 22, 2024

✔ NPI 1780455527 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

601 VERSAILLES RD, Frankfort, KY 40601

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Other Names 1

Doing Business AsCenterwell Senior Primary Care- Eastside

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 18D0958340

Centerwell Senior Primary Care (ky) Psc Dba Centerwell Eastside · Frankfort, KY

Active · expires Sep 13, 2026

CLIA Number18D0958340

Laboratory TypePhysician Office

Certificate Effective DateSeptember 14, 2024

Certificate Expiration DateSeptember 13, 2026

Laboratory DirectorDr. Misha K. Rhodes

Laboratory Phone(502) 695-3946

Laboratory LocationCenterwell Senior Primary Care (ky) Psc Dba Centerwell Eastside601 Versailles Road, Frankfort, KY 40601

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 10

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

MRS. NISHA ASHOK PATEL PRABHU PA-C

Physician Assistant (Medical)