NPIMap

Organization Active NPI

Pinnacle Orthopaedics & Sports Medicine Specialists, LLC

  • Orthopaedic Surgery Physician
  • Acworth, GA
National Provider Identifier
1386908184
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
31591 Issued in GA
Legal business name
PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS, LLC
Practice address
4550 Cobb Parkway NW
Suite 309G
Acworth, GA 30101-0000
Phone
(678) 213-5717
Fax
(678) 213-5723
NPI assigned
Jun 27, 2012
Last updated
Oct 22, 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 Oct 22, 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
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 31591 GA Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 65285 GA

Addresses

Primary practice location

4550 Cobb Parkway NW
Suite 309G
Acworth, GA 30101-0000

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303001053 GA Part B Supplier - Clinic/Group Practice 6204723216 Receives reassigned benefits from 74 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, GA; Dallas, GA; Hiram, GA; Marietta, GA; Woodstock, GA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Orthopaedics Sports Medicine15 organizations share this tax ID, including this one
Part of
Pinnacle Orthopaedics Sports Medicine

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 6

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": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1386908184",
    "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": "770-514-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 COBB PARKWAY NW",
            "address_2": "SUITE 309G",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301010000",
            "telephone_number": "678-213-5717",
            "fax_number": "678-213-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS, LLC",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-10-22",
        "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": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "31591",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "65285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.