Active NPI
Raleigh Capitol Ear, Nose, and Throat
- Otolaryngology Physician
- Raleigh, NC
National Provider Identifier
1902170442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PE-YPU8T38FA | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
300 Health Park Dr
Garner, NC 27529
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
10208 Cerny St
Raleigh, NC 27617
Phone (919) 234-4468
10208 Cerny St
Ste 300
Raleigh, NC 27617
Phone (919) 354-1290
835 Wake Forest Business Park
Ste B
Wake Forest, NC 27587
Practitioners & affiliated clinicians
Practitioners 52
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": "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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PE-YPU8T38FA",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
- Raleigh Accident & Injury Center
- Raleigh Acupuncture Inc
- Raleigh Adult Medicine PA
- Raleigh Associated Medical Specialists Inc
- Raleigh Best Medical Supply and Home Health Care Services, LLC
- Raleigh Cardiology Associates, PA
- Raleigh Center for Neurosurgery & Neurosciences, PA
- Raleigh Children & Adolescents Medicine, PC
- Raleigh Chiropractic and Wellness
- Raleigh Counseling Associates, PLLC
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.