NPIMap

Organization Active NPI

Centerwell Senior Primary Care (SC) PC

Doing business as CenterWell Senior Primary Care-Orchard Park

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1376907790
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CENTERWELL SENIOR PRIMARY CARE (SC) PC
Doing business as
CenterWell Senior Primary Care-Orchard Park
Partners in Primary Care-Orchard Park
Practice address
101 Orchard Park Dr
Greenville, SC 29615-3531
Phone
(864) 729-6606
Fax
(855) 617-4426
NPI assigned
Apr 12, 2016
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTERWELL SENIOR PRIMARY CARE (SC) PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie Martinez
Title
Senior Credentialing Professional
Phone
(407) 447-7120

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

101 Orchard Park Dr
Greenville, SC 29615-3531

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other names 4

  • CenterWell Senior Primary Care-Orchard Park Doing business as
  • Partners in Primary Care-Orchard Park Doing business as
  • Partners in Primary Care NC PC Former legal business name
  • Partners in Primary Care SC PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160808001129 SC Part B Supplier - Clinic/Group Practice 8729302278 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Greenville, SC; Greer, SC
O20201216002926 SC Part B Supplier - Clinic/Group Practice 2860804796 Receives reassigned benefits from 85 practitioners
8 other NPIs on this enrollment
Practice locations: Greenville, SC; Spartanburg, SC; Seneca, SC; North Charleston, SC; Greer, SC; Charleston, SC; Anderson, SC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2114511Centerwell Senior Primary Care - Orchard Park101 Orchard Park Drive, Greenville, SC 29615Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Centerwell Senior Primary Care NC PC4 organizations share this tax ID, including this one
Part of
Centerwell Senior Primary Care NC PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4918 Ayers St
Ste 130
Corpus Christi, TX 78415
Phone (361) 400-4355

5718 Spohn Dr
Ste 100
Corpus Christi, TX 78414
Phone (361) 980-0808

10435 Vista del Sol Dr
El Paso, TX 79925
Phone (915) 591-6229

1211 E Cliff Dr
El Paso, TX 79902
Phone (915) 533-8147

1105 Oak St
Ste A
Jourdanton, TX 78026
Phone (830) 769-2181

12602 Toepperwein Rd
Ste 100
Live Oak, TX 78233
Phone (210) 620-9669

4359 Greco Dr
San Antonio, TX 78222
Phone (210) 648-8200

4455 Thousand Oaks Dr
San Antonio, TX 78233
Phone (726) 268-7360

4522 Fredericksburg Rd
Ste A14
San Antonio, TX 78201
Phone (210) 733-3005

5920 FM 78
San Antonio, TX 78244
Phone (210) 662-0076

6801 San Pedro Ave
San Antonio, TX 78216
Phone (726) 224-2300

1354 E Walnut St
Seguin, TX 78155
Phone (830) 401-0025

Practitioners & affiliated clinicians

Practitioners 257

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 257

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1376907790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ORCHARD PARK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153531",
            "telephone_number": "864-729-6606",
            "fax_number": "855-617-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL SENIOR PRIMARY CARE (SC) PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTERWELL SENIOR PRIMARY CARE (SC) PC",
        "enumeration_date": "2016-04-12",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING PROFESSIONAL",
        "authorized_official_telephone_number": "407-447-7120"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CenterWell Senior Primary Care-Orchard Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Partners in Primary Care-Orchard Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Partners in Primary Care NC PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Partners in Primary Care NC PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Partners in Primary Care SC PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.