Centerwell Senior Primary Care SC Jv PC
NPI 1962101501ActiveOrganization· Internal Medicine· West Columbia, SC
Internal Medicine in West Columbia, South Carolina, registered in NPPES in March 2023, part of Centerwell Senior Primary Care SC Jv PC. The authorized official on file is Angie Martinez, Senior Credentialing Professional. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962101501 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Centerwell Senior Primary Care SC Jv PC |
| NPI issued | Mar 2, 2023 |
| Last updated in NPPES | Aug 19, 2024 |
| Certified by provider | Aug 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| General Practice | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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