Pinnacle Treatment Centers VA-I, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

PINNACLE TREATMENT CENTERS VA-I, LLC

Doing business as

FCCR Fredericksburg

Practice address

11720 Main St Ste 108
Fredericksburg, VA 22408

Phone

(540) 735-9350

NPI assigned

Nov 14, 2017

Last updated

Nov 21, 2023By 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

Robyn Tanis

Title

Executive Director of Contract MGMT

Phone

(856) 533-8762

Specialties & licenses 3

Addresses

Other names 1

• FCCR Fredericksburg Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pinnacle Treatment Centers VA-I, LLC

  dba FCCR Southlake

  • Methadone Clinic
  • North Chesterfield, VA
  • NPI 1558874461

  O20200130000451

  Same enrollment
• Pinnacle Treatment Centers VA-I, LLC

  dba FCCR Radford

  • Methadone Clinic
  • Richmond, VA
  • NPI 1750872966

  O20200130000451

  Same enrollment
• Pinnacle Treatment Centers VA-I, LLC

  dba Front Royal Treatment Center

  • Methadone Clinic
  • Front Royal, VA
  • NPI 1821717067

  O20200130000451

  Same enrollment

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Heaven Bailey-Hogan, LCSW

  • Clinical Social Worker
  • Fredericksburg, VA
  • NPI 1588457170
  NPD (past)
• Mitchell Ira Burken, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Fredericksburg, VA
  • NPI 1407402506
  NPD (past)
• Judith M. Schmidt, L.C.S.W.

  • Addiction (Substance Use Disorder) Counselor
  • Richmond, VA
  • NPI 1831227149
  NPD (past)
• Kristin Deslauriers Baynard, LCSW

  • Counselor
  • Lewes, DE
  • NPI 1083253322
  NPD (past)

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1356854277",
    "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": "11720 MAIN ST STE 108",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22408",
            "telephone_number": "540-735-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS VA-I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCCR Fredericksburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Anneliese Pilkington-Hardison, MD
• Kaitlen Pinckney
• Tanisha Pink-Gayle, WHNP-BC
• Pinnacle Dermatology, S.C.
• Pinnacle Dermatology, SC (Pinnacle Dermatology, Fredericksburg)
• Amanda Piper, FNP-BC
• Sarah Mae E Pippen, FNP-C
• Donna Wilson Pirnat, LMT
• Ianna Simone Borys Pirozzi
• Alyssa Pisano

• Methadone Clinic in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Methadone Clinic in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.