Centerwell Senior Primary Care-new Albany | |
305 New Albany Plz New Albany IN 47150-4653 | |
(812) 668-8133 | |
(877) 772-5818 |
Full Name | Centerwell Senior Primary Care-new Albany |
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Speciality | Internal Medicine |
Location | 305 New Albany Plz, New Albany, Indiana |
Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
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-new Albany 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care-new Albany 305 New Albany Plz New Albany IN 47150-4653 Ph: (812) 668-8133 |
NPI Number | 1942900030 |
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Provider Enumeration Date | 03/07/2023 |
Last Update Date | 07/01/2024 |
Medicare PECOS PAC ID | 2466826177 |
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Medicare Enrollment ID | O20230321000696 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942900030 | 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 | Kimberlee A Sickels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174556468 PECOS PAC ID: 4385638592 Enrollment ID: I20040412000735 |
Provider Name | Giavonne D Rondo Hillman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124083514 PECOS PAC ID: 8729050976 Enrollment ID: I20040809001327 |
Provider Name | Steven Gray |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326033887 PECOS PAC ID: 6406996537 Enrollment ID: I20091221000306 |
Provider Name | Vernon Osburn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144569203 PECOS PAC ID: 8628214483 Enrollment ID: I20130423000420 |
Provider Name | Tara S Wakefield |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427490762 PECOS PAC ID: 1557595097 Enrollment ID: I20131016000521 |
Provider Name | Bassem Adie |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1174613889 PECOS PAC ID: 7810966348 Enrollment ID: I20140709001541 |
Provider Name | Ashley K Mundil |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225511033 PECOS PAC ID: 7517210743 Enrollment ID: I20181105002235 |
Provider Name | Melissa Ann Hail |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346719184 PECOS PAC ID: 1355680281 Enrollment ID: I20190311002115 |
Provider Name | Janel J Willingham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609018423 PECOS PAC ID: 6901956051 Enrollment ID: I20210413001572 |
Provider Name | Rachael K Agbonhese |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760988356 PECOS PAC ID: 4688922891 Enrollment ID: I20210928001451 |
Provider Name | Ashlee R Mack |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942811682 PECOS PAC ID: 4183043755 Enrollment ID: I20211012002358 |
Provider Name | Erica Woodson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376145110 PECOS PAC ID: 0244631356 Enrollment ID: I20211118001004 |
Provider Name | Erica Lache' Savage-jeter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275657694 PECOS PAC ID: 9739234584 Enrollment ID: I20230321000782 |
Provider Name | David P Wasserman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598781288 PECOS PAC ID: 7517977598 Enrollment ID: I20230719003882 |
Provider Name | Madison Davis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831687003 PECOS PAC ID: 0345574422 Enrollment ID: I20230818002878 |
Provider Name | Tracy Elam |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1699957704 PECOS PAC ID: 2062878754 Enrollment ID: I20230918002150 |
Provider Name | Kenquisha M Moorman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437648789 PECOS PAC ID: 9133484439 Enrollment ID: I20230918002199 |
Provider Name | Alexandria M Salois |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700331535 PECOS PAC ID: 2860770351 Enrollment ID: I20230921000737 |
Provider Name | Mark Miller |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558474130 PECOS PAC ID: 7214031715 Enrollment ID: I20230927000750 |
Provider Name | Ifunanya Ojukwu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518525708 PECOS PAC ID: 9032443056 Enrollment ID: I20231002001894 |
Provider Name | Dana Singletary |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518453075 PECOS PAC ID: 7810245495 Enrollment ID: I20231102002843 |
Provider Name | Tamea Evans |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1376501700 PECOS PAC ID: 9537166533 Enrollment ID: I20231127001307 |
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