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

Centerwell Senior Primary Care SC Jv PC

Organization Family Medicine Physician · NPI 1356040992

Centerwell Senior Primary Care SC Jv PC is a Family Medicine Physician in Columbia, South Carolina. Registered with an NPI since 2023.

In the registry since
2023
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

2738 Decker Blvd Ste A
Columbia, SC 29206-1735
Phone: (803) 969-0543
Fax: (877) 958-9029
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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 number1356040992
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care SC Jv PC
Authorized official Angie Martinez — Senior Credentialing Professional · (407) 447-7120
Other names Centerwell Senior Primary Care-Decker Blvd
NPI enumeratedMarch 2, 2023
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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