CAPITAL CITY MEDICAL GROUP, LLC (NPI# 1487084943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487084943 |
| Entity Type | Organization |
| Organization Name | CAPITAL CITY MEDICAL GROUP, LLC |
| Other Organization Name | PRIMARY CARE PLUS |
| Practice Address |
120 Meadowcrest St Suite 120 Gretna LA 70056-5255 |
| Mailing Address |
3838 N Causeway Blvd Suite 2200 Metairie LA 70002-8194 |
| Practice Telephone | 5046205661 |
| Practice Fax Number | 5046205674 |
| Mailing Telephone | 5046818259 |
| Mailing Fax Number | 5046818260 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2014-05-12 |
| Authorized Official Name | MR. PETER ALDEN KELLOGG (ASSOCIATE GENERAL COUNSEL) |
| Authorized Official Telephone | 5046818532 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primary Care Plus | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225449374 | Capital City Medical Group, LLC | Internal Medicine | 7049 Perkins Rd, Baton Rouge, LA 70808 | 2014-05-12 |
| 1881963858 | Capital City Medical Group, LLC | Specialist | 16777 Medical Center Dr, Suite 400, Baton Rouge, LA 70816-3254 | 2011-12-21 |
| Street Address |
120 MEADOWCREST ST SUITE 120 |
| City | GRETNA |
| State | LA |
| Zip Code | 70056-5255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568467769 | James P Marra | Specialist | 120 Meadowcrest St, Ste 380, Gretna, LA 70056-5281 | 2005-06-15 |
| 1851852362 | Monica Idoyaga | Nurse Practitioner | 120 Meadowcrest St, Ste 245, Gretna, LA 70056-5280 | 2019-03-27 |
| 1205379203 | Jamila Mathews | Nurse Practitioner | 120 Meadowcrest St, Gretna, LA 70056-5255 | 2016-11-22 |
| 1336487206 | Lupin Womens Health Services, LLC | Obstetrics & Gynecology | 120 Meadowcrest St, Suite 350, Gretna, LA 70056-5255 | 2013-01-28 |
| 1700144102 | Kim Phung Thi Nguyen | Pharmacist | 120 Meadowcrest St, Suite 150, Gretna, LA 70056-5255 | 2012-04-24 |
| 1962702175 | Daniel A Long Md A Professional Medical Corporation | Clinic/Center | 120 Meadowcrest St, #330, Gretna, LA 70056-5255 | 2010-10-22 |
| 1205064631 | Ochsner Clinic LLC | Durable Medical Equipment & Medical Supplies | 120 Meadowcrest St, Gretna, LA 70056-5255 | 2009-06-24 |
| 1063648525 | Daniel J Burst | Physician Assistant | 120 Meadowcrest St, Suite 300, Gretna, LA 70056-5255 | 2009-06-10 |
| 1518100312 | Crescent City Dermatology, LLC | Dermatology | 120 Meadowcrest St, Suite 460, Gretna, LA 70056-5255 | 2009-04-09 |
| 1841431038 | Teri C Bairnsfather | Audiologist | 120 Meadowcrest St, Suite 200, Gretna, LA 70056-5255 | 2009-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023634169 | Krewe Wellness | Counselor | 2112 Belle Chasse Hwy Ste 8, #156, Gretna, LA 70056 | 2020-06-24 |
| 1205459732 | Gulf Coast Medical Specialists LLC | Internal Medicine | 1620 Belle Chasse Hwy Suite 101, Gretna, LA 70056 | 2020-05-19 |
| 1427530872 | Anna Marie Mckeon Jr. | Social Worker | 410 W. Butterfly Circle, Terrytown, LA 70056 | 2018-09-02 |
| 1558843219 | Nikell Thompson Fortia | Non-emergency Medical Transport (VAN) | 561 Morningside Dr, Gretna, LA 70056 | 2018-08-29 |
| 1861979379 | Irajuan L Cooley | Case Manager/Care Coordinator | 1620 Carol Sue Ave Apt 219, Gretna, LA 70056 | 2018-07-26 |
| 1457842528 | Veronica Stevenson | Case Manager/Care Coordinator | 1799 Stumpf Blvd Ste 4a, Terrytown, LA 70056 | 2018-05-24 |
| 1184126278 | Elesha Loston | Case Manager/Care Coordinator | 1799 Stumpf Blvd. Bldg .7 Suite 9a, Gretna, LA 70056 | 2018-03-05 |
| 1336656149 | Porsha D Causey | Counselor | 1799 Stumpf Blvd Bldg 7 Ste 10, Ste 10, Gretna, LA 70056 | 2018-01-02 |
| 1265950745 | Tamika Nicole Deville | Counselor | Advanced Therapeutic, 1799 Stumpf Blvd Bld 3 Ste 4b, Terrytown, LA 70056 | 2017-09-05 |
| 1679098792 | Clear Head Inc | Clinic/Center | 2310 Park Place Dr., Terrytown, LA 70056 | 2017-08-09 |
| Find all providers in zip 70056 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205459732 | Gulf Coast Medical Specialists LLC | Internal Medicine | 1620 Belle Chasse Hwy Suite 101, Gretna, LA 70056 | 2020-05-19 |
| 1205011517 | Zia Rehman Khan | Internal Medicine | 1120 Newton St, Gretna, LA 70053-6340 | 2008-01-04 |
| 1558572446 | Kendria E. Holt-rogers | Internal Medicine | 501 Lapalco Blvd, Gretna, LA 70056-7336 | 2007-05-24 |
| 1902955990 | Betty Jean Dowty | Internal Medicine | 548 Lapalco Blvd, Gretna, LA 70056-7305 | 2007-01-09 |
| 1235295551 | Hai Nam Nguyen | Internal Medicine | 1221 Amelia St, Gretna, LA 70053-5533 | 2006-12-29 |
| 1508963968 | Dyess Medical Center Incorporated | Internal Medicine | # 12 Westside Expressway, Gretna, LA 70053 | 2006-09-20 |
| 1386749653 | James Malcolm Dyess | Internal Medicine | 12 Westbank Expy, Gretna, LA 70053-3647 | 2006-09-13 |
| 1992762603 | Christy Lynn Valentine | Internal Medicine | 145 Lapalco Blvd, Suite B, Gretna, LA 70056-7149 | 2006-04-27 |
| 1023086287 | Sarath Bose Battula | Internal Medicine | 2500 Belle Chasse Hwy., Gretna, LA 70056 | 2006-03-14 |
| 1740276229 | Ralph F Cameron | Internal Medicine | 175 Hector Ave, Gretna, LA 70056-2590 | 2005-09-21 |
| Find all providers in GRETNA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.