Pinnacle Radiology LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

PINNACLE RADIOLOGY LLC

Practice address

490 N Washington Ave
Titusville, FL 32796-2871

Phone

(321) 268-4200

NPI assigned

Mar 5, 2008

Last updated

Feb 23, 2011By 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

Kenneth S Hazlett, M.D.

Title

Managing Member

Phone

(321) 799-9172

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1205006343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881839",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349881839",
            "telephone_number": "727-896-3134",
            "fax_number": "770-666-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962871",
            "telephone_number": "321-268-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE RADIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "HAZLETT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "321-799-9172",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AM098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Merrill Phillips, R.PH
• Monell Phillips
• Noelle Phillips, PT
• Paul James Pierce, PTA
• Sherry Duskie Pierce, CRNA
• Derek William Pisana
• Marius Joseph Pitre, PHARM.D.
• Kevin Norbert Plamondon
• Play Move Grow Pediatric Therapy, LLC
• Jananya Plianrungsi

• Diagnostic Radiology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.