Capital City Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CAPITAL CITY MEDICAL GROUP, LLC

Practice address

120 Meadowcrest St
Suite 120
Gretna, LA 70056-5255

Phone

(504) 620-5661

Fax

(504) 620-5674

NPI assigned

Nov 20, 2013

Organization subpart

No

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 3

Addresses

Other names 1

• Primary Care Plus Doing business as

Tax ID family

Capital City Medical Group LLC3 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.

• Capital City Medical Group, LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1225449374
  NPD tax ID
• Capital City Medical Group, LLC

  • Specialist
  • Baton Rouge, LA
  • NPI 1881963858
  NPD tax ID

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1487084943",
    "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": "120 MEADOWCREST ST",
            "address_2": "SUITE 120",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-620-5661",
            "fax_number": "504-620-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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"
        }
    ]
}

• Ralph F Cameron, MD
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• Adam C Campbell Jr., CRT
• Emily Navarro Campbell
• Jose Alfredo Cano, MD
• Ashley Constance Carey, LPC
• Mandy Rae Carmouche, NNP-BC
• Dian Caronna, PT
• Carr Drugs
• Carr Drugs Compounding & Wellness

• Internal Medicine Physician in Gretna, LA
• Providers in Gretna, LA by specialty
• Internal Medicine Physician in Louisiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.