NPIMap

Organization Active NPI

Pinnacle Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Price, UT
National Provider Identifier
1144313669
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 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
Last updated
Sep 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Todd William Johnson, MD
Title
President
Phone
(888) 304-6796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000864 UT Part B Supplier - Clinic/Group Practice 0648175455 Receives reassigned benefits from 12 practitioners
Practice locations: Price, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1144313669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3750",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103750",
            "telephone_number": "888-304-6796",
            "fax_number": "801-432-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N HOSPITAL DRIVE",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "84501",
            "telephone_number": "435-637-4800",
            "fax_number": "801-432-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-304-6796",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.