NPIMap

Organization Active NPI

Capitol City Speech Therapy

  • Developmental Therapist
  • Fuquay Varina, NC
National Provider Identifier
1508052556
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
4178 Issued in NC
Legal business name
CAPITOL CITY SPEECH THERAPY
Practice address
141 N Main St
Fuquay Varina, NC 27526-1933
Phone
(919) 577-6807
NPI assigned
Sep 23, 2007
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Tracy BarnesNPI 1992814503
Title
Owner/Manager
Phone
(919) 577-6807

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU
Developmental Therapist 222Q00000X 4178 NC Primary

Addresses

Primary practice location

141 N Main St
Fuquay Varina, NC 27526-1933

Mailing address

141 N Main St
Fuquay Varina, NC 27526-1933
Phone (919) 577-6807

Other identifiers 1

IdentifierTypeStateIssuer
8300172MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Capitol City Speech Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1508052556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261933",
            "telephone_number": "919-577-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261933",
            "telephone_number": "919-577-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL CITY SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-23",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "919-577-6807"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NC",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300172",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.