NPIMap

Organization Active NPI

Pinnacle Plastic Surgery Associates LLC

  • Plastic Surgery Physician
  • Rincon, GA
National Provider Identifier
1356214696
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PINNACLE PLASTIC SURGERY ASSOCIATES LLC
Practice address
812 Towne Park Dr Ste 100
Rincon, GA 31326-9365
Phone
(843) 815-6699
Fax
(843) 815-6695
NPI assigned
Sep 24, 2025
Last updated
Sep 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Authorized official

Name
Audrey KlenkeNPI 1386833770
Title
Owner
Phone
(843) 815-6699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

812 Towne Park Dr Ste 100
Rincon, GA 31326-9365

Mailing address

7 Mallett Way
Bluffton, SC 29910-6064
Phone (843) 815-6699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251106001410 GA Part B Supplier - Clinic/Group Practice 7214171198 Receives reassigned benefits from 2 practitioners
Practice locations: Rincon, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Plastic Surgery Associates LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

812 Towne Park Dr
Ste 100
Rincon, GA 31326
Phone (843) 815-6699

7 Mallett Way
Bluffton, SC 29910
Phone (513) 543-7648

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1356214696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MALLETT WAY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106064",
            "telephone_number": "843-815-6699",
            "fax_number": "843-815-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 TOWNE PARK DR STE 100",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269365",
            "telephone_number": "843-815-6699",
            "fax_number": "843-815-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PLASTIC SURGERY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "KLENKE",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-815-6699"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.