NPIMap

Organization Active NPI

Capital Surgical Specialists, PA

  • Surgery Physician
  • Louisburg, NC
National Provider Identifier
1730150558
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAPITAL SURGICAL SPECIALISTS, PA
Practice address
1501 N Bickett Blvd
Suite a
Louisburg, NC 27549-2178
Phone
(919) 496-1050
Fax
(919) 496-0191
NPI assigned
Jan 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Hollis Tidmore, MDNPI 1962473975
Title
President
Phone
(919) 496-1050

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1501 N Bickett Blvd
Suite a
Louisburg, NC 27549-2178

Mailing address

1501 N Bickett Blvd
Suite a
Louisburg, NC 27549-2178
Phone (919) 496-1050

National Provider Directory

National Provider Directory

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": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1730150558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N BICKETT BLVD",
            "address_2": "SUITE A",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492178",
            "telephone_number": "919-496-1050",
            "fax_number": "919-496-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N BICKETT BLVD",
            "address_2": "SUITE A",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492178",
            "telephone_number": "919-496-1050",
            "fax_number": "919-496-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL SURGICAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "TIDMORE",
        "authorized_official_first_name": "HOLLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-496-1050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.