NPIMap

Organization Active NPI

Pinnacle Treatment Centers Oh-VI, LLC

  • Methadone Clinic
  • Cincinnati, OH
National Provider Identifier
1043726797
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PINNACLE TREATMENT CENTERS OH-VI, LLC
Practice address
5122 Glencrossing Way
Cincinnati, OH 45238-3361
Phone
(513) 827-9044
Fax
(513) 827-1332
NPI assigned
Dec 18, 2017
Organization subpart
Yes
Parent organization
PINNACLE TREATMENT CENTERS OH-1, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Authorized official

Name
Robyn Tanis
Title
Executive Director Contract MGMT
Phone
(856) 533-8762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

5122 Glencrossing Way
Cincinnati, OH 45238-3361

Mailing address

1317 Route 73
Mount Laurel, NJ 08054-2202
Phone (856) 533-8762

Other names 1

  • Covedale Treatment Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200402003435 OH Part B Supplier - Opioid Treatment Program (Otp) 7719316348 Practice locations: Cincinnati, OH

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2139324Pinnacle Treatment Centers Oh-VI, LLC5122 Glencrossing Way, Cincinnati, OH 45238Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory
Part of
Pinnacle Treatment Centers Oh-I LLC

Locations

5122 Glencrossing Way
Cincinnati, OH 45238
Phone (513) 827-9044

Practitioners & affiliated clinicians

Practitioners 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1043726797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-533-8762",
            "fax_number": "856-780-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 GLENCROSSING WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383361",
            "telephone_number": "513-827-9044",
            "fax_number": "513-827-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS OH-VI, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE TREATMENT CENTERS OH-1, LLC",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covedale Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.