NPIMap

Organization Active NPI

Capital City Medical Group, L.L.C.

  • Internal Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1144522855
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAPITAL CITY MEDICAL GROUP, L.L.C.
Practice address
2645 Oneal LN
Baton Rouge, LA 70816-3179
Phone
(225) 926-7200
Fax
(225) 706-2182
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Mr. Peter Alden Kellogg
Title
Associate General Counsel
Phone
(504) 681-8532

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

2645 Oneal LN
Baton Rouge, LA 70816-3179

Mailing address

3838 N Causeway Blvd
Suite 2200
Metairie, LA 70002-8194
Phone (504) 681-8259

Other names 1

  • Primary Care Plus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110405000902 LA Part B Supplier - Clinic/Group Practice 8628252392 Receives reassigned benefits from 38 practitioners
Practice locations: Westwego, LA; Slidell, LA; New Orleans, LA; Hammond, LA; Monroe, LA; Lafayette, LA; Houma, LA; Gonzales, LA…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2645 Oneal Ln
Bldg D
Baton Rouge, LA 70816
Phone (225) 926-7200

4710 Oneal Ln
Ste 112
Baton Rouge, LA 70817
Phone (225) 926-7200

2645 Oneal Ln
Bldg C-C
Baton Rouge, LA 70816
Phone (225) 326-4637

7045 Perkins Rd
Baton Rouge, LA 70808

1702 N Burnside Ave
#A
Gonzales, LA 70737
Phone (225) 647-8319

42078 Veterans Ave
Ste E2
Hammond, LA 70403
Phone (985) 727-8075

42078 Veterans Ave
Ste E
Hammond, LA 70403

3838 N Causeway Blvd
Ste 2550
Metairie, LA 70002

2461 Tower Dr
Monroe, LA 71201
Phone (318) 323-7576

2633 Napoleon Ave
New Orleans, LA 70115
Phone (504) 897-4571

3010 Holiday Dr
New Orleans, LA 70131
Phone (504) 620-5661

Practitioners & affiliated clinicians

Practitioners 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1144522855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N CAUSEWAY BLVD",
            "address_2": "SUITE 2200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700028194",
            "telephone_number": "504-681-8259",
            "fax_number": "504-681-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 ONEAL LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708163179",
            "telephone_number": "225-926-7200",
            "fax_number": "225-706-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY MEDICAL GROUP, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "ALDEN",
        "authorized_official_title_or_position": "ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "504-681-8532",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.