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CAPSTONE MEDICAL CLINIC LLC
NPI 1407436462
Internal Medicine in Perry, GA

Active since April 13, 2021CLIA 11D0715433 · Microscopy
1023 KEITH DR, PERRY, GA 31069(478) 988-1100(478) 988-8211 Get Directions Write a Review

NPPES record last updated: April 13, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Capstone Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAPSTONE MEDICAL CLINIC LLC (NPI 1407436462) is a healthcare organization registered as an internal medicine in Perry, Georgia and active in the NPI registry since April 2021. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Brenda Bozaard, Cred/billing Manager, as its authorized official.

NPPES Registry Identity

NPI1407436462
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCAPSTONE MEDICAL CLINIC LLC
Location Address1023 KEITH DRPerry, GA 31069-2948
Mailing Address1023 Keith DrPerry, GA 31069-2948 · (478) 988-1100 · Fax (478) 988-8211
Phone(478) 988-1100
Fax(478) 988-8211
Organization SubpartNo
Authorized OfficialBrenda BozaardCred/billing Manager · (478) 333-6468
Enumeration DateApril 13, 2021
NPPES CertifiedApril 13, 2021
✔ NPI 1407436462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
1023 KEITH DR, Perry, GA 31069
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0715433

Capstone Medical Clinic · Perry, GA
Active · expires Aug 31, 2026
CLIA Number11D0715433
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorGerald K. Brantley
Laboratory Phone(912) 988-1100
Laboratory LocationCapstone Medical Clinic1019 Keith Drive, Perry, GA 31069
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRY E. HAM MD
Internal Medicine
1023 KEITH DR
PERRY, GA 31069
Houston County (478) 988-1100
GERALD K. BRANTLEY MD
Internal Medicine
1023 KEITH DR
PERRY, GA 31069
Houston County (478) 988-1100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Capstone Medical Clinic LLC's NPI number?

The NPI number for Capstone Medical Clinic LLC is 1407436462. It was assigned to this organization in the NPPES registry on April 13, 2021.

Where is Capstone Medical Clinic LLC located?

Capstone Medical Clinic LLC is located at 1023 Keith Dr, Perry, GA 31069. The listed phone number is (478) 988-1100.

What is Capstone Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Capstone Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D0715433) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Capstone Medical Clinic LLC was last updated on April 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.