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CENTERWELL SENIOR PRIMARY CARE NC JV PC
NPI 1942074950
Internal Medicine in Charlotte, NC

Active since November 09, 2023CLIA 34D2297898 · Waiver
5415 SOUTH BLVD, CHARLOTTE, NC 28217(704) 869-0321(877) 977-5366 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Centerwell Senior Primary Care Nc Jv Pc NPPES

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

CENTERWELL SENIOR PRIMARY CARE NC JV PC (NPI 1942074950) is a healthcare organization registered as an internal medicine in Charlotte, North Carolina and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through January 23, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1942074950
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE NC JV PC
Location Address5415 SOUTH BLVDCharlotte, NC 28217-4119
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120
Phone(704) 869-0321
Fax(877) 977-5366
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateNovember 9, 2023
NPPES CertifiedNovember 9, 2023
✔ NPI 1942074950 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
5415 SOUTH BLVD, Charlotte, NC 28217
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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 34D2297898

Centerwell Senior Primary Care-Montclaire · Charlotte, NC
Active · expires Jan 23, 2028
CLIA Number34D2297898
Laboratory TypePhysician Office
Certificate Effective DateJanuary 24, 2026
Certificate Expiration DateJanuary 23, 2028
Laboratory DirectorErica Savage-Jeter
Laboratory Phone(704) 869-0321
Laboratory LocationCenterwell Senior Primary Care-Montclaire5415 South Blvd, Charlotte, NC 28217
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Nc Jv PC's NPI number?

The NPI number for Centerwell Senior Primary Care Nc Jv PC is 1942074950. It was assigned to this organization in the NPPES registry on November 9, 2023.

Where is Centerwell Senior Primary Care Nc Jv PC located?

Centerwell Senior Primary Care Nc Jv PC is located at 5415 South Blvd, Charlotte, NC 28217. The listed phone number is (704) 869-0321.

What is Centerwell Senior Primary Care Nc Jv PC's specialty?

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

Does Centerwell Senior Primary Care Nc Jv PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2297898) is associated with this NPI, valid through January 23, 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 Nc Jv PC was last updated on November 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.