Organization Active NPI

Capital Family Medicine, P.a.

  • Primary Care Clinic/Center
  • Raleigh, NC
National Provider Identifier
1124007620
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
40821 Issued in NC
Legal business name
CAPITAL FAMILY MEDICINE, P.A.
Practice address
3320 Executive Dr
Suite 214
Raleigh, NC 27609-7445
Phone
(919) 878-8596
Fax
(919) 878-0744
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard J Forsyth, M.D.NPI 1114968401
Title
President
Phone
(919) 878-8596

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 40821 NC Primary

Addresses

Primary practice location

3320 Executive Dr
Suite 214
Raleigh, NC 27609-7445

Mailing address

3320 Executive Dr
Suite 214
Raleigh, NC 27609-7445
Phone (919) 878-8596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050121000477 NC Part B Supplier - Clinic/Group Practice 8628027166 Receives reassigned benefits from 14 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

908 W Williams St
Apex, NC 27502

10831 Forest Pines Dr
Ste 104
Raleigh, NC 27614
Phone (919) 488-8066

3320 Executive Dr
Ste 214
Raleigh, NC 27609
Phone (919) 878-8596

1422 E Millbrook Rd
Raleigh, NC 27609
Phone (919) 876-4064

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124007620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 EXECUTIVE DR",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097445",
            "telephone_number": "919-878-8596",
            "fax_number": "919-878-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 EXECUTIVE DR",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097445",
            "telephone_number": "919-878-8596",
            "fax_number": "919-878-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL FAMILY MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORSYTH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-878-8596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "40821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.