Pinnacle Physical Therapy & Sports Medicine LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT010208 Issued in GA

Legal business name

PINNACLE PHYSICAL THERAPY & SPORTS MEDICINE LLC

Practice address

789 Highway 96 Ste 2B
Bonaire, GA 31005-3357

Phone

(478) 302-5111

Fax

(478) 225-6453

NPI assigned

Feb 15, 2018

Last updated

Dec 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Shane Valigora, DPTNPI 1598992760

Title

Physical Therapist

Phone

(478) 919-7442

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• William Shane Valigora, DPT

  • Physical Therapist
  • Bonaire, GA
  • NPI 1598992760
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1063912178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 HIGHWAY 96 STE 2B",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053357",
            "telephone_number": "478-302-5111",
            "fax_number": "478-225-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 HIGHWAY 96 STE 2B",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053357",
            "telephone_number": "478-302-5111",
            "fax_number": "478-225-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PHYSICAL THERAPY & SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-15",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "VALIGORA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "478-919-7442",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "PT010208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Bonaire, GA
• Providers in Bonaire, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.