Pinnacle Enrichment Healthcare Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PINNACLE ENRICHMENT HEALTHCARE SERVICES, LLC

Doing business as

Pinnacle Enrichment Healthcare Services,LLC

Practice address

7700 Old Branch Ave Ste E101
Clinton, MD 20735-1628

Phone

(301) 877-1400

Fax

(301) 576-7968

NPI assigned

Sep 11, 2015

Last updated

Aug 2, 2024By 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

Dr. Myron V Johnson

Title

Owner

Phone

(901) 270-8002

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pinnacle Enrichment Healthcare Services,LLC Doing business as

Locations

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1144698812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE STE E101",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "301-877-1400",
            "fax_number": "301-576-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE STE E101",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "301-877-1400",
            "fax_number": "301-576-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ENRICHMENT HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-270-8002",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130016401",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Enrichment Healthcare Services,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nakita Porter
• Neil Pothraj, MD

• Community/Behavioral Health Agency in Clinton, MD
• Providers in Clinton, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.