Individual provider Active NPI

Valerie Capuy Ertle, M.D.

  • Pediatrics Physician
  • Augusta, GA
National Provider Identifier
1245619592
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
83314 Issued in GA
Practice address
1111 Garredd Blvd Ste a
Augusta, GA 30909-6751
Phone
(706) 863-6674
Fax
(706) 868-7057
NPI assigned
May 20, 2015
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 83314 GA Primary

Addresses

Primary practice location

1111 Garredd Blvd Ste a
Augusta, GA 30909-6751

Mailing address

2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440

Other names 1

  • Dr. Valerie Ann Capuy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721000621 GA Practitioner - Pediatric Medicine 4486956026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83314GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Improvement Project, Inc CurrentSince Jul 1, 2020 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

1111 Garredd Blvd
Augusta, GA 30909
Phone (706) 296-6507

1111 Garredd Blvd
Ste A
Augusta, GA 30909
Phone (706) 863-5776

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1245619592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 GOLDEN CAMP RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065515",
            "telephone_number": "706-790-4440",
            "fax_number": "706-790-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GARREDD BLVD STE A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096751",
            "telephone_number": "706-863-6674",
            "fax_number": "706-868-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTLE",
        "first_name": "VALERIE",
        "middle_name": "CAPUY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "83314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "CAPUY",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.