Pinnacle Medical Clinic Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

14467 Issued in MS

Legal business name

PINNACLE MEDICAL CLINIC INC

Doing business as

PINNACLE MEDICAL CLINIC

Practice address

7900 Highway 570
Summit, MS 39666-7563

Phone

(601) 684-7771

Fax

(601) 684-1616

NPI assigned

Dec 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David P Smith, MD, FAAFP

Title

Ceo

Phone

(601) 684-7771

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PINNACLE MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 258968

Legal name

PINNACLE MEDICAL CLINIC INC

Doing business as

PINNACLE MEDICAL CLINIC INC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 28, 2003

Last certification

Feb 9, 2022

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Feb 9, 2000 in MS

Enrollment address

7900 Hwy 570 W
Summit, MS 39666

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Joseph Lee Dykes, FNP

  • Nurse Practitioner
  • Summit, MS
  • NPI 1396123402

  5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracilee Grace Dykes, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Summit, MS
  • NPI 1851016562

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Joseph Lee Dykes, FNP

  • Nurse Practitioner
  • Summit, MS
  • NPI 1396123402
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1043493851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 HIGHWAY 570",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396667563",
            "telephone_number": "601-684-7771",
            "fax_number": "601-684-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 HIGHWAY 570",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396667563",
            "telephone_number": "601-684-7771",
            "fax_number": "601-684-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-684-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FAAFP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "14467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03522321",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINNACLE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kailee Ann Phillips, M.S., CF-SLP
• Tiffany Phillips
• Phoenix Healthcare, LLC
• Christie Pierce
• Dianna Pinkerton
• Pixies Pantry, LLC
• Jordan Spears Porter, MS, CCC-SLP
• Leslie Posey
• Tanya K Powell, PTA, BS
• Alexandra Moore Price, DO

• Rural Health Clinic/Center in Summit, MS
• Providers in Summit, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.