NPIMap

Organization Active NPI

Pinnacle Orthopaedics & Sports Medicine Specia

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kennesaw, GA
National Provider Identifier
1235405747
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
31591 Issued in GA
Legal business name
PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIA
Practice address
1000 Chastain Road
Building II
Kennesaw, GA 30144-0000
Phone
(770) 427-5717
Fax
(770) 514-5040
NPI assigned
Mar 29, 2012
Last updated
Mar 29, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Donna L Fisher, CAO
Title
Chief Administrative Officer
Phone
(770) 429-7741

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 64509 GA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 31591 GA Primary

Addresses

Primary practice location

1000 Chastain Road
Building II
Kennesaw, GA 30144-0000

Mailing address

300 Tower Road
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Orthopaedics Sports Medicine Specialists LLC15 organizations share this tax ID, including this one
Part of
Pinnacle Orthopaedics Sports Medicine Specialists LLC

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1000 Chastain Rd NW
Bldg Ii
Kennesaw, GA 30144
Phone (770) 427-5717

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1235405747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER ROAD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHASTAIN ROAD",
            "address_2": "BUILDING II",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301440000",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS, LLC",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "770-429-7741",
        "authorized_official_credential": "CAO"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "64509",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "31591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.