NPIMap

Organization Active NPI

Capitol City Speech Therapy, LLC

  • Speech-Language Pathologist
  • Fuquay Varina, NC
National Provider Identifier
1689755241
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4178 Issued in NC
Legal business name
CAPITOL CITY SPEECH THERAPY, LLC
Practice address
141 N Main St
Fuquay Varina, NC 27526-1933
Phone
(919) 577-6807
Fax
(919) 577-6853
NPI assigned
Oct 18, 2006
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Ms. Tracy Lorrine Barnes, MS CCC-SLPNPI 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 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 practice location 1

6845 Knightdale Blvd Ste 102
Knightdale, NC 27545-9800
Phone (919) 577-6807

Other practice location 2

1330 Saint Marys St Ste 100
Raleigh, NC 27605-3334
Phone (919) 577-6807

Other identifiers 6

IdentifierTypeStateIssuer
1359HOtherNCBC/BS INDIVIDUAL NUMBER
7412076MedicaidNC
D3268OtherNCMEDCOST INDIVIDUAL NUMBER
016U8OtherNCBC/BS GROUP NUMBER
7211674MedicaidNC
A9389OtherNCMEDCOST GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091201000533 NC Part B Supplier - Clinic/Group Practice 5799824991 Receives reassigned benefits from 5 practitioners
Practice locations: Fuquay Varina, NC; Raleigh, NC

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.

Locations

6523 Johnson Pond Rd
Fuquay Varina, NC 27526

1305 Glenwood Ave
Raleigh, NC 27605
Phone (919) 899-6474

1330 Saint Marys St
Ste 100
Raleigh, NC 27605
Phone (919) 577-6807

1520 Glenwood Ave
#201
Raleigh, NC 27608
Phone (919) 577-6807

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1689755241",
    "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",
            "fax_number": "919-577-6853"
        },
        {
            "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",
            "fax_number": "919-577-6853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6845 Knightdale Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275459800",
            "country_code": "US",
            "telephone_number": "919-577-6807",
            "fax_number": "919-577-6853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1330 Saint Marys St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276053334",
            "country_code": "US",
            "telephone_number": "919-577-6807",
            "fax_number": "919-577-6853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAPITOL CITY SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LORRINE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "919-577-6807",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL NUMBER",
            "identifier": "1359H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412076",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST INDIVIDUAL NUMBER",
            "identifier": "D3268",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP NUMBER",
            "identifier": "016U8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211674",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST GROUP NUMBER",
            "identifier": "A9389",
            "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 Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.