Centerwell Senior Primary Care TN CS PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTERWELL SENIOR PRIMARY CARE TN CS PC

Practice address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Phone

(407) 447-7120

Fax

(407) 770-0661

NPI assigned

Aug 5, 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 TN

Enrollment records 1

Practitioners 4

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

• Dekozlymn Anderson, CRNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1134556061

  TN

  Medicare reassignment NPD
• Anitha Lakshmi Mullangi, M.D

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1972722254

  Family Medicine, TN

  Medicare reassignment NPD
• Damien Bailey, APRN

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

  TN

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

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1275657694

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1992689467",
    "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",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "407-447-7120",
            "fax_number": "407-770-0661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1947 Madison St Ste B",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438033",
            "country_code": "US",
            "telephone_number": "407-447-7120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTERWELL SENIOR PRIMARY CARE TN CS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "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": []
}

• Centerwell Senior Primary Care Ga CS PC
• Centerwell Senior Primary Care Ga PC
• Centerwell Senior Primary Care Il CS PC
• Centerwell Senior Primary Care Ky CS PSC
• Centerwell Senior Primary Care NV P C
• Centerwell Senior Primary Care TN PC
• Centerwell Senior Primary Care TX CS PA
• Central Florida Health Partners Inc
• Central Health Corp
• Central Health Corp.

• All providers in Miami, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.