Centerwell Senior Primary Care-old National | |
6085 Old National Hwy Ste G South Fulton GA 30349-4333 | |
(470) 754-6360 | |
(877) 780-7359 |
Full Name | Centerwell Senior Primary Care-old National |
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Speciality | Internal Medicine |
Location | 6085 Old National Hwy Ste G, South Fulton, Georgia |
Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING SPECIALIST) |
Authorized Official Contact | 4074477120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centerwell Senior Primary Care-old National 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care-old National 6085 Old National Hwy Ste G South Fulton GA 30349-4333 Ph: (470) 754-6360 |
NPI Number | 1801463468 |
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Provider Enumeration Date | 06/10/2021 |
Last Update Date | 07/03/2024 |
Medicare PECOS PAC ID | 3274939061 |
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Medicare Enrollment ID | O20210901004313 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801463468 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208D00000X | General Practice | (* (Not Available)) | Secondary |
Provider Name | Gloria A Richards |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043311186 PECOS PAC ID: 1456318088 Enrollment ID: I20041215000899 |
Provider Name | Adebukola O Akintoye |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447380019 PECOS PAC ID: 4587696927 Enrollment ID: I20050907000058 |
Provider Name | Abiola Ojewole |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306011077 PECOS PAC ID: 4981769346 Enrollment ID: I20090218000409 |
Provider Name | John Joseph Oliga |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1013021781 PECOS PAC ID: 4688729080 Enrollment ID: I20090909000275 |
Provider Name | Dmitriy M Pelishev |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457400251 PECOS PAC ID: 9436246659 Enrollment ID: I20091028000423 |
Provider Name | Rita Claxton |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306855655 PECOS PAC ID: 9638178148 Enrollment ID: I20110906000535 |
Provider Name | Denni M Savage |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851732416 PECOS PAC ID: 9638311517 Enrollment ID: I20130805000878 |
Provider Name | Sherika S Newman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740442599 PECOS PAC ID: 6103993233 Enrollment ID: I20140311001582 |
Provider Name | Lenise M Jordan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639595309 PECOS PAC ID: 3476778085 Enrollment ID: I20140715000928 |
Provider Name | Wendy Swayne |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730580010 PECOS PAC ID: 6103048947 Enrollment ID: I20141112001039 |
Provider Name | Meredith Banks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710386883 PECOS PAC ID: 2860719291 Enrollment ID: I20150324002240 |
Provider Name | Kimberly N Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265987184 PECOS PAC ID: 5890081020 Enrollment ID: I20160914000602 |
Provider Name | Emily Battaglia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508300690 PECOS PAC ID: 2668753708 Enrollment ID: I20170103000771 |
Provider Name | Tse-hwa J Yin |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053602045 PECOS PAC ID: 2769626126 Enrollment ID: I20170124001771 |
Provider Name | Lonnie Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639616089 PECOS PAC ID: 7911281183 Enrollment ID: I20170307002025 |
Provider Name | Donell D Collins |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427499136 PECOS PAC ID: 9032346127 Enrollment ID: I20170901001556 |
Provider Name | Vannessa Evans |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1467968099 PECOS PAC ID: 9638426216 Enrollment ID: I20180728000079 |
Provider Name | Jan Delroy Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023518537 PECOS PAC ID: 8628328234 Enrollment ID: I20180831001238 |
Provider Name | Erica D Ware |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942692843 PECOS PAC ID: 2062717341 Enrollment ID: I20190218003055 |
Provider Name | Michelle Rochard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265890487 PECOS PAC ID: 5890078620 Enrollment ID: I20191228000391 |
Provider Name | Sara Morris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861984759 PECOS PAC ID: 9638504327 Enrollment ID: I20200128001031 |
Provider Name | Debra Ann Stover |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679076525 PECOS PAC ID: 9133556269 Enrollment ID: I20200229000199 |
Provider Name | Leisa Covington |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700339728 PECOS PAC ID: 3274962121 Enrollment ID: I20200330000139 |
Provider Name | Jamay R Logan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114489911 PECOS PAC ID: 5991127730 Enrollment ID: I20200623003504 |
Provider Name | Stella Royette Thomas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487292694 PECOS PAC ID: 7517379142 Enrollment ID: I20201223001305 |
Provider Name | Ouida Deedra Carr |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326649351 PECOS PAC ID: 3274946744 Enrollment ID: I20201231000681 |
Provider Name | April Jonita Scott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619514437 PECOS PAC ID: 2466865878 Enrollment ID: I20210104000625 |
Provider Name | Shonkeisha L Byrd |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043828106 PECOS PAC ID: 2668885567 Enrollment ID: I20210114001444 |
Provider Name | Jarvis Jeffrey Sanchez-rivera |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659521797 PECOS PAC ID: 8628263696 Enrollment ID: I20210910000667 |
Provider Name | Donessa A Fraser |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255561379 PECOS PAC ID: 5698923019 Enrollment ID: I20210915000112 |
Provider Name | Randa Pycard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851809529 PECOS PAC ID: 0840552550 Enrollment ID: I20211006003226 |
Provider Name | Jodine Sejour Donatien |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275562332 PECOS PAC ID: 6800819368 Enrollment ID: I20211014000063 |
Provider Name | Elaine Grimes-dixon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790453934 PECOS PAC ID: 5799173530 Enrollment ID: I20211027000669 |
Provider Name | Tamika Crawford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902357510 PECOS PAC ID: 8628321213 Enrollment ID: I20211115001118 |
Provider Name | Oladunni Funmi Faminu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861040479 PECOS PAC ID: 6709276264 Enrollment ID: I20211124001653 |
Provider Name | Kiana Rosella Green |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114539764 PECOS PAC ID: 3577959949 Enrollment ID: I20220412000896 |
Provider Name | Joseph Fowlkes |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568661320 PECOS PAC ID: 3678960911 Enrollment ID: I20220505000153 |
Provider Name | Neva R Allison |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346759974 PECOS PAC ID: 9133509615 Enrollment ID: I20220629003313 |
Provider Name | Henny P Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336753920 PECOS PAC ID: 0648655217 Enrollment ID: I20220917000103 |
Provider Name | Chekeli Virginia Daniels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134827355 PECOS PAC ID: 6709224306 Enrollment ID: I20240402001389 |
Soul Serene Wellness And Medspa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5835 Campbellton Rd Sw Ste 103, South Fulton, GA 30331 Phone: 404-549-2505 |