NPIMap

Organization Active NPI

Capital Digestive Care, LLC

Doing business as Capital Digestive Care- Princess Anne

  • Gastroenterology Physician
  • Virginia Beach, VA
National Provider Identifier
1912193350
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CAPITAL DIGESTIVE CARE, LLC
Doing business as
Capital Digestive Care- Princess Anne
Practice address
1925 Glenn Mitchell Dr
Suite 102
Virginia Beach, VA 23456-0170
Phone
(757) 464-1644
Fax
(757) 363-1071
NPI assigned
Sep 19, 2007
Last updated
Aug 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CAPITAL DIGESTIVE CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Authorized official

Name
Timothy Short
Title
Ceo
Phone
(757) 803-6483

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1925 Glenn Mitchell Dr
Suite 102
Virginia Beach, VA 23456-0170

Mailing address

10770 Columbia Pike Ste 400
Silver Spring, MD 20901-4462
Phone (240) 485-5210

Other names 2

  • Capital Digestive Care- Princess Anne Doing business as
  • GASTROINTESTINAL & LIVER SPECIALIST OF TIDEWATER PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211124000446 VA Part B Supplier - Clinic/Group Practice 3870669419 Receives reassigned benefits from 202 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chesapeake, VA; Williamsburg, VA; Virginia Beach, VA; Suffolk, VA; Newport News, VA; Norfolk, VA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2149655Capital Digestive Care1925 Glenn Mitchell Drive, Suite 102, Virginia Beach, VA 23456Certificate of waiverJun 7, 2028

National Provider Directory

National Provider Directory

Locations

1020 Independence Blvd
Bldg 110
Virginia Bch, VA 23455

1925 Glenn Mitchell Dr
Ste 102
Virginia Beach, VA 23456
Phone (757) 464-1644

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1912193350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10770 COLUMBIA PIKE STE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014462",
            "telephone_number": "240-485-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 GLENN MITCHELL DR",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560170",
            "telephone_number": "757-464-1644",
            "fax_number": "757-363-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DIGESTIVE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAPITAL DIGESTIVE CARE, LLC",
        "enumeration_date": "2007-09-19",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-803-6483"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Digestive Care- Princess Anne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capital Digestive Care- Princess Anne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GASTROINTESTINAL & LIVER SPECIALIST OF TIDEWATER PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.