Pinnacle Anesthesia Associates, LLC
Organization Active NPI Anesthesiology Physician · Price, UT
NPI 1144313669 · NPPES record last updated Sep 14, 2009
Key facts
- NPI
- 1144313669
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- PINNACLE ANESTHESIA ASSOCIATES, LLC
- Practice address
- 300 N Hospital Drive
Price, UT 84501 - Phone
- (435) 637-4800
- Fax
- (801) 432-2670
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Todd William Johnson, MD
- Title
- President
- Phone
- (888) 304-6796
Practitioners 12
-
Darin H Latimer, DO
-
Joshua S Vincent, CRNA
-
Adam Bigelow, RN
-
Benjamin Richard King, CRNA
-
Jay H Gassman, CRNA
-
Scott Miller, CRNA
-
Gary A Wiscombe, CRNA
-
Richard Ivan Anderson, CRNA
-
Aaron Iverson, CRNA
-
Trent W. Sigler, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031204000864 | UT | Part B Supplier - Clinic/Group Practice | 0648175455 |
Receives reassigned benefits from 12 practitioners Practice locations: Price, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
300 N Hospital Drive
Price, UT 84501
Mailing address
PO Box 3750
Salt Lake City, UT 84110-3750
Phone (888) 304-6796
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27041325001 | Medicaid | UT |
Other providers in Price, UT
- Lacey Pell
- Danielle Howa Pendergrass
- Gloria Pendleton
- Douglas Wilford Perkins
- Pine Top Medical P.C.
- Pinnacle Psychiatry & Behavioral Health PLLC
- Donald Ray Polster
- Justin Pope
- Brittnay Popejoy
- Positive Pathways
All providers in Price, UT · Anesthesiology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.