NPIMap

Organization Active NPI

Capital Digestive Care, LLC

  • Gastroenterology Physician
  • Columbia, MD
National Provider Identifier
1104664648
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CAPITAL DIGESTIVE CARE, LLC
Practice address
6230 Old Dobbin LN Ste 150
Columbia, MD 21045-5809
Phone
(410) 730-9363
Fax
(410) 730-2084
NPI assigned
Jul 18, 2024
Organization subpart
Yes
Parent organization
CAPITAL DIGESTIVE CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Timothy Short
Title
Ceo
Phone
(757) 803-6483

Specialties & licenses 1

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

Addresses

Primary practice location

6230 Old Dobbin LN Ste 150
Columbia, MD 21045-5809

Mailing address

10770 Columbia Pike Ste 400
Silver Spring, MD 20901-4462
Phone (240) 485-5200

Other practice location 1

5500 Knoll North Dr Ste 460
Columbia, MD 21045-2380
Phone (410) 730-9363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081031000296 MD Part B Supplier - Clinic/Group Practice 3870669419 Receives reassigned benefits from 42 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, MD; Frederick, MD; Ijamsville, MD; Salisbury, MD

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0888155Capital Digestive Care, LLC6230 Old Dobbin Kane Suite 150, Columbia, MD 21045Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Capital Digestive Care LLC13 organizations share this tax ID, including this one
Part of
Capital Digestive Care LLC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1104664648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10770 COLUMBIA PIKE STE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014462",
            "telephone_number": "240-485-5200",
            "fax_number": "301-576-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 OLD DOBBIN LN STE 150",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455809",
            "telephone_number": "410-730-9363",
            "fax_number": "410-730-2084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Knoll North Dr Ste 460",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452380",
            "country_code": "US",
            "telephone_number": "410-730-9363",
            "fax_number": "410-730-2084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAPITAL DIGESTIVE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAPITAL DIGESTIVE CARE, LLC",
        "enumeration_date": "2024-07-18",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-803-6483"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.