Organization Active NPI

Capitol Urology Medical Group Inc

  • Urology Physician
  • Folsom, CA
National Provider Identifier
1306867213
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CAPITOL UROLOGY MEDICAL GROUP INC
Practice address
1561 Creekside Dr
Suite 170
Folsom, CA 95630
Phone
(916) 983-5557
Fax
(916) 983-7878
NPI assigned
Jul 23, 2006
Last updated
Nov 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Authorized official

Name
Joyce Myers
Title
Practice Manager
Phone
(916) 983-5557

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G59349 CA
Urology Physician 208800000X Primary

Addresses

Primary practice location

1561 Creekside Dr
Suite 170
Folsom, CA 95630

Mailing address

1561 Creekside Dr
Suite 170
Folsom, CA 95630-3492
Phone (916) 983-5557

Other identifiers 1

IdentifierTypeStateIssuer
GR0065840MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Capitol Urology Medical Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1306867213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 CREEKSIDE DR",
            "address_2": "SUITE 170",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303492",
            "telephone_number": "916-983-5557",
            "fax_number": "916-983-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 CREEKSIDE DR",
            "address_2": "SUITE 170",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-983-5557",
            "fax_number": "916-983-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL UROLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "916-983-5557"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G59349",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.