Centerwell Senior Primary Care (NC), P.C.
Organization Active NPI Internal Medicine Physician · Greensboro, NC
NPI 1225858723 · NPPES record last updated Jan 24, 2025
Key facts
- NPI
- 1225858723
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CENTERWELL SENIOR PRIMARY CARE (NC), P.C.
- Practice address
- 2703 W Gate City Blvd Ste J
Greensboro, NC 27403-3130 - Phone
- (336) 790-5400
- Fax
- (336) 790-2714
- NPI assigned
- Oct 10, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTERWELL SENIOR PRIMARY CARE (NC), P.C.
Authorized official
- Name
- Angie Martinez
- Title
- Senior Credentialing Professional
- Phone
- (407) 447-7120
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 6
Practitioners 2
-
Deneda Thomas Daye, FNP
-
Jennifer Alfafara, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171016002152 | NC | Part B Supplier - Clinic/Group Practice | 2264708486 |
Receives reassigned benefits from 65 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Burlington, NC; Gastonia, NC; Greensboro, NC; Winston Salem, NC |
National Provider Directory
- Tax ID family
- Centerwell Senior Primary Care NC PC
- Part of
- Centerwell Senior Primary Care NC PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| General Practice Physician |
208D00000X | |||
| Non-Pharmacy Dispensing Site | 332900000X |
Addresses
Primary practice location
2703 W Gate City Blvd Ste J
Greensboro, NC 27403-3130
Mailing address
6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Other names
- CenterWell Senior Primary Care (NC), P.C. - Meadowood
Other providers in Greensboro, NC
- Center for Vein Restoration NC PLLC
- Center of Progressive Strides Inc
- Center of Progressive Strides, Inc
- Center of Progressive Strides, Inc.
- Centerwell Certified Healthcare Corp.
- Central Carolina Counseling Associates, PLLC
- Central Carolina Health Network
- Central Carolina OB/GYN
- Central Carolina Obstetrics & Gynecology PLLC
- Central Carolina Surgery, P.a.
All providers in Greensboro, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.