Organization Active NPI

Capital Pediatrics, PLLC

  • Pediatrics Physician
  • Olympia, WA
National Provider Identifier
1619137635
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CAPITAL PEDIATRICS, PLLC
Practice address
2112 Caton Way SW
Olympia, WA 98502-1105
Phone
(360) 754-1629
Fax
(360) 754-1964
NPI assigned
Jun 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Janet Ness
Title
Office Manager
Phone
(360) 754-1629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2112 Caton Way SW
Olympia, WA 98502-1105

Mailing address

2112 Caton Way SW
Olympia, WA 98502-1105
Phone (360) 754-1629

Other identifiers 1

IdentifierTypeStateIssuer
1120641MedicaidWA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2276186Capital Pediatrics PLLC2112 Caton Way SW, Olympia, WA 98502Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

509 Missouri Blvd
Jefferson City, MO 65101

1616 Southridge Dr
Jefferson Cty, MO 65109
Phone (573) 635-2800

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1619137635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 CATON WAY SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021105",
            "telephone_number": "360-754-1629",
            "fax_number": "360-754-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 CATON WAY SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021105",
            "telephone_number": "360-754-1629",
            "fax_number": "360-754-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "NESS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-754-1629"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1120641",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.