NPIMap

Organization Active NPI

Capital Digestive Care, LLC

  • Gastroenterology Physician
  • Rockville, MD
National Provider Identifier
1104664655
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CAPITAL DIGESTIVE CARE, LLC
Practice address
15001 Shady Grove Rd Ste 300
Rockville, MD 20850-6353
Phone
(301) 340-3252
Fax
(301) 593-4781
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 Aug 26, 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

15001 Shady Grove Rd Ste 300
Rockville, MD 20850-6353

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080905000450 DC Part B Supplier - Clinic/Group Practice 3870669419 Receives reassigned benefits from 121 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Takoma Park, MD; Silver Spring, MD; Rockville, MD; Temple Hills, MD; Washington, DC; Bethesda, MD; Bowie, MD; Chevy Chase, MD…

Other NPIs on the same Medicare enrollment 11

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
21D2170639Capital Digestive Care LLC15001 Shady Grove Rd, Rockville, MD 20850Certificate of waiverAug 14, 2027

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.

Locations

15001 Shady Grove Rd
Ste 300
Rockville, MD 20850
Phone (301) 340-3252

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": "1756166400000",
    "number": "1104664655",
    "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": "15001 SHADY GROVE RD STE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506353",
            "telephone_number": "301-340-3252",
            "fax_number": "301-593-4781"
        }
    ],
    "practiceLocations": [],
    "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": "2025-08-26",
        "certification_date": "2025-08-26",
        "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 Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.