CAPITAL CENTER FOR FUNCTIONAL MEDICINE LLC
NPI 1922496462
Internal Medicine in Bethesda, MD

Q: What is Capital Center For Functional Medicine LLC's specialty?

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

Active since January 07, 2015CLIA 21D2308143 · Waiver

4701 SANGAMORE RD STE N270, BETHESDA, MD 20816(240) 507-5110 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 6, 2024, Nov 12, 2024, Dec 16, 2022 (3 updates tracked since 2022).

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About Capital Center For Functional Medicine Llc NPPES

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

CAPITAL CENTER FOR FUNCTIONAL MEDICINE LLC (NPI 1922496462) is a healthcare organization registered as an internal medicine in Bethesda, Maryland and active in the NPI registry since January 2015. The organization holds a CLIA Waiver certificate valid through July 22, 2028, maintains a secondary practice location in Potomac, and lists Andrew Wong, Founder And Medical Director, as its authorized official.

NPPES Registry Identity

NPI1922496462

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCAPITAL CENTER FOR FUNCTIONAL MEDICINE LLC

Location Address4701 SANGAMORE RD STE N270Bethesda, MD 20816-2528

Mailing Address416 Green Pasture DrRockville, MD 20852-4233 · (301) 892-2658

Phone(240) 507-5110

Organization SubpartNo

Authorized OfficialAndrew WongFounder And Medical Director · (301) 892-2658

Enumeration DateJanuary 7, 2015

Last NPPES UpdateDecember 6, 20243 updates tracked since enumeration

NPPES CertifiedDecember 6, 2024

✔ NPI 1922496462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MD · D66066

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.

4701 SANGAMORE RD STE N270, Bethesda, MD 20816

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Secondary Practice Location 1

Location 111325 Seven Locks Rd Ste N290Potomac, MD 20854-3205 · Phone (240) 507-5110

Other Identifiers 1

Medicaid014051100MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 of Waiver 21D2308143

Capital Center For Functional Medicine LLC · Potomac, MD

Active · expires Jul 22, 2028

CLIA Number21D2308143

Laboratory TypePhysician Office

Certificate Effective DateJuly 23, 2026

Certificate Expiration DateJuly 22, 2028

Laboratory DirectorAndrew Wong

Laboratory Phone(240) 507-5110

Laboratory LocationCapital Center For Functional Medicine LLC11325 Seven Locks Rd Suite 290, Potomac, MD 20854

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

CAPITAL INTEGRATIVE HEALTH

Internal Medicine