NPIMap

Organization Active NPI

Pinnacle Family Medicine PA

  • Family Medicine Physician
  • Spring Hill, FL
National Provider Identifier
1265644876
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME88431 Issued in FL
Legal business name
PINNACLE FAMILY MEDICINE PA
Practice address
120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220
Phone
(352) 688-2118
Fax
(352) 688-3118
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Charles C Sullivan, MD MBA
Title
President
Phone
(352) 688-2118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME88431 FL Primary

Addresses

Primary practice location

120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220

Mailing address

120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220
Phone (352) 688-2118

Other identifiers 2

IdentifierTypeStateIssuer
K5407OtherFLMEDICARE ID
37656OtherFLBCBS

National Provider Directory

National Provider Directory

Locations

120 Medical Blvd
Ste 108
Spring Hill, FL 34609
Phone (352) 688-2118

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1265644876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEDICAL BLVD",
            "address_2": "SUITE 108",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090220",
            "telephone_number": "352-688-2118",
            "fax_number": "352-688-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL BLVD",
            "address_2": "SUITE 108",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090220",
            "telephone_number": "352-688-2118",
            "fax_number": "352-688-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-688-2118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME88431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "K5407",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37656",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.