Capital City Medical Group, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CAPITAL CITY MEDICAL GROUP, LLC

Doing business as

Stanocola Clinic Ancillary Services

Practice address

16777 Medical Center Dr
Suite 400
Baton Rouge, LA 70816-3254

Phone

(225) 952-8798

Fax

(225) 952-8502

NPI assigned

Dec 21, 2011

Last updated

Dec 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ronnie Johnson

Title

Chief Executive Officer

Phone

(225) 926-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stanocola Clinic Ancillary Services 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

  dba Primary Care Plus

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

  dba Primary Care Plus

  • Internal Medicine Physician
  • Gretna, LA
  • NPI 1487084943
  NPD tax ID

Locations

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1881963858",
    "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": "225-926-7200",
            "fax_number": "225-952-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16777 MEDICAL CENTER DR",
            "address_2": "SUITE 400",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708163254",
            "telephone_number": "225-952-8798",
            "fax_number": "225-952-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "225-926-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2142674",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanocola Clinic Ancillary Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Capital Area Human Services District School Based Services
• Capital City Chiropractic Group LLC
• Capital City Counseling, LLC
• Capital City Medical Group, L.L.C. (Primary Care Plus)
• Capital City Medical Group, LLC (Primary Care Plus)
• Capital City Transit Services LLC
• Capital City Transportation LLC.
• Capital Eyes LLC
• Capital Healthcare Consutants, LLC
• Capital Oaks Nursing & Rehabilitation Center LLC

• Specialist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.