Centerwell Senior Primary Care la CS PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTERWELL SENIOR PRIMARY CARE LA CS PC

Practice address

7551 Youree Dr Ste 11
Shreveport, LA 71105-5533

Phone

(318) 642-9282

NPI assigned

Apr 14, 2025

Organization subpart

No

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

Authorized official

Name

Angie S Martinez

Title

Senior Credentialing Professional

Phone

(407) 447-7120

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Earl Kyle Magee, M.D.

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1508887977
  Medicare reassignment NPD
• Dekozlymn Anderson, CRNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1134556061

  LA

  Medicare reassignment NPD
• Kelsey Deidrick, MD

  • Internal Medicine Physician
  • Wilton Manors, FL
  • NPI 1265091391

  LA

  Medicare reassignment NPD
• Nada Sareini, AGNP

  • Gerontology Nurse Practitioner
  • Detroit, MI
  • NPI 1578069357

  LA

  Medicare reassignment NPD
• Damien Bailey, APRN

  • Family Nurse Practitioner
  • New York, NY
  • NPI 1043518087

  LA

  Medicare reassignment
• Erica Lache' Savage-Jeter, M.D.

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1275657694
  NPD (past)

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1952196495",
    "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": "407-447-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 YOUREE DR STE 11",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055533",
            "telephone_number": "318-642-9282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6101 Blue Lagoon Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331263168",
            "country_code": "US",
            "telephone_number": "407-447-7120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTERWELL SENIOR PRIMARY CARE LA CS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING PROFESSIONAL",
        "authorized_official_telephone_number": "407-447-7120"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Centerwell Senior Primary Care (la) PC
• Centerwell Senior Primary Care (la) PC
• Diana Paola Cera, MS., PLPC
• Peter Andrew Cernigliaro III, CRNA
• Samantha Lea Cetta, BSN, RN, SRNA
• CG Concierge & in Home Personal Care
• Meghna Chadha, MD

• Internal Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.