NPIMap

Organization Active NPI

Capital City Gastroenterology, PC

Doing business as Capital City Gatsroenterology

  • Gastroenterology Physician
  • Montgomery, AL
National Provider Identifier
1073587523
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CAPITAL CITY GASTROENTEROLOGY, PC
Doing business as
Capital City Gatsroenterology
Practice address
4126 Carmichael CT
Montgomery, AL 36106-2871
Phone
(334) 495-2600
Fax
(334) 495-2604
NPI assigned
Feb 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Chandi Butler
Title
Administrator
Phone
(334) 239-9257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

4126 Carmichael CT
Montgomery, AL 36106-2871

Mailing address

4126 Carmichael CT
Montgomery, AL 36106-2871
Phone (334) 495-2600

Other practice location 1

7065 Sydney Curv
Montgomery, AL 36117-3509
Phone (334) 495-2600

Other identifiers 1

IdentifierTypeStateIssuer
01D1026965OtherCLIA WAIVER

Other names 1

  • Capital City Gatsroenterology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000235 AL Part B Supplier - Clinic/Group Practice 6800887530 Receives reassigned benefits from 11 practitioners
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

440 Taylor Rd
Montgomery, AL 36117
Phone (224) 213-6255

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1390

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1073587523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 CARMICHAEL CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062871",
            "telephone_number": "334-495-2600",
            "fax_number": "334-495-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 CARMICHAEL CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062871",
            "telephone_number": "334-495-2600",
            "fax_number": "334-495-2604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7065 Sydney Curv",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361173509",
            "country_code": "US",
            "telephone_number": "334-495-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAPITAL CITY GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "CHANDI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-239-9257",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "01D1026965",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital City Gatsroenterology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.