NPIMap

Organization Active NPI

Pinnacle Orthopaedics & Sports Medicine Specialists LLC

  • Orthopaedic Surgery Physician
  • Canton, GA
National Provider Identifier
1053453852
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS LLC
Practice address
720 Transit Ave
Suite 202
Canton, GA 30114
Phone
(770) 345-5717
Fax
(770) 345-7852
NPI assigned
Feb 12, 2007
Last updated
Nov 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Authorized official

Name
Donna Fisher
Title
Administrator
Phone
(770) 427-5717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

720 Transit Ave
Suite 202
Canton, GA 30114

Mailing address

300 Tower Road
Suite 101
Marietta, GA 30060-9403
Phone (770) 218-0219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040303001053 GA Part B Supplier - Clinic/Group Practice 6204723216 Receives reassigned benefits from 74 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, GA; Dallas, GA; Hiram, GA; Marietta, GA; Woodstock, GA
O20100930040956 GA DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Sports MedicineDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 6204723216 Practice locations: Canton, GA

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Orthopaedics Sports Medicine15 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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1053453852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER ROAD",
            "address_2": "SUITE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-218-0219",
            "fax_number": "770-590-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "770-345-5717",
            "fax_number": "770-345-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-427-5717"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.