NPIMap

Organization Active NPI

Raleigh Capitol Ear, Nose, and Throat

  • Otolaryngology Physician
  • Raleigh, NC
National Provider Identifier
1902170442
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
RALEIGH CAPITOL EAR, NOSE, AND THROAT
Practice address
4600 Lake Boone TRL
Raleigh, NC 27607-7528
Phone
(919) 787-1374
Fax
(919) 420-2028
NPI assigned
Mar 1, 2012
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Jenny C Beal, COPM
Title
Billing Manager
Phone
(919) 809-8140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4600 Lake Boone TRL
Raleigh, NC 27607-7528

Mailing address

4600 Lake Boone TRL
Raleigh, NC 27607-7528
Phone (919) 787-1374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120703000428 NC Part B Supplier - Clinic/Group Practice 2860657509 Receives reassigned benefits from 43 practitioners
Practice locations: Wake Forest, NC; Raleigh, NC; Garner, NC; Cary, NC

National Provider Directory

National Provider Directory

Locations

300 Health Park Dr
Ste 210
Garner, NC 27529
Phone (919) 662-8181

2051 Ralph Stephens Rd
Holly Springs, NC 27540

4600 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 787-1374

4600 Lake Boone Trl
Ste 2100
Raleigh, NC 27607

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1902170442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077528",
            "telephone_number": "919-787-1374",
            "fax_number": "919-571-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077528",
            "telephone_number": "919-787-1374",
            "fax_number": "919-420-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH CAPITOL EAR, NOSE, AND THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "919-809-8140",
        "authorized_official_credential": "COPM"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.