Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Centerwell Senior Primary Care MS PC

Organization Family Medicine Physician · NPI 1003528092

Centerwell Senior Primary Care MS PC is a Family Medicine Physician in Gulfport, Mississippi. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12057 Highway 49 Ste C
Gulfport, MS 39503-3177
Phone: (228) 832-9385
Fax: (877) 504-6444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1003528092
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care MS PC
Authorized official Angie Martinez — Senior Credentialing Professional · (407) 447-7120
Other names Centerwell Senior Primary Care-Gulfport; Centerwell Senior Primary Care-Gulfport
NPI enumeratedDecember 21, 2022
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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