NPIMap

Organization Active NPI

Pinnacle Treatment Centers Oh-VII, LLC

  • Methadone Clinic
  • Elyria, OH
National Provider Identifier
1295382646
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PINNACLE TREATMENT CENTERS OH-VII, LLC
Practice address
174 Midway Blvd
Elyria, OH 44035-2786
Phone
(440) 723-8997
NPI assigned
Aug 21, 2019
Last updated
Dec 23, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PINNACLE TREATMENT CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Robyn Tanis
Title
Executive Director of Contract Mana
Phone
(856) 533-8762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

174 Midway Blvd
Elyria, OH 44035-2786

Mailing address

1317 Route 73
Mount Laurel, NJ 08054-2202
Phone (856) 533-8762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Opioid treatment program
Medicare-enrolled since Aug 22, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201130001914 OH Part B Supplier - Opioid Treatment Program (Otp) 1850702630 Practice locations: Elyria, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2166921Pinnacle Treatment Centers Oh-VII174 Midway Blvd, Elyria, OH 44035Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1295382646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-533-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MIDWAY BLVD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352786",
            "telephone_number": "440-723-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS OH-VII, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE TREATMENT CENTERS, INC.",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MANA",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.