NPIMap

Organization Active NPI

Pinnacle Orthopaedics & Sports Medicine Specialists LLC

  • Specialist
  • Marietta, GA
National Provider Identifier
1003367707
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS LLC
Practice address
300 Tower Rd NE
Suite 100
Marietta, GA 30060-9404
Phone
(770) 499-9118
Fax
(770) 792-8276
NPI assigned
Oct 18, 2016
Last updated
Oct 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Donna L Fisher
Title
Chief Administrative Officer
Phone
(770) 427-5717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

300 Tower Rd NE
Suite 100
Marietta, GA 30060-9404

Mailing address

300 Tower Rd NE
Suite 101
Marietta, GA 30060-9404
Phone (770) 427-5717

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200422001921 GA DME Supplier - Physician - General PracticeDME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 6204723216 Practice locations: Marietta, GA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Orthopaedics Sports Medicine Specia15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

4550 Cobb Parkway North NW
Ste 309G
Acworth, GA 30101
Phone (678) 213-5717

144 Bill Carruth Pkwy
Ste 4700
Hiram, GA 30141
Phone (678) 453-5717

80 Interstate South Dr
#A
Jasper, GA 30143
Phone (706) 692-1575

5205 Stilesboro Rd NW
Kennesaw, GA 30152
Phone (678) 278-8345

300 Tower Rd NE
Marietta, GA 30060
Phone (770) 427-5714

Practitioners & affiliated clinicians

Practitioners 77

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 77

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1003367707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE",
            "address_2": "SUITE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609404",
            "telephone_number": "770-427-5717",
            "fax_number": "770-792-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609404",
            "telephone_number": "770-499-9118",
            "fax_number": "770-792-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "770-427-5717"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.

Verify at the official NPI Registry.