NPIMap

Organization Active NPI

Pinnacle Family Medicine, PLLC

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1396067310
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36828 Issued in CO
Legal business name
PINNACLE FAMILY MEDICINE, PLLC
Practice address
1040 S 8TH Street
Suite 102
Colorado Springs, CO 80905
Phone
(719) 687-8752
Fax
(719) 687-8753
NPI assigned
Feb 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Authorized official

Name
Dr. Michelle Ann Eads, MDNPI 1801881305
Title
President/Owner
Phone
(719) 687-8752

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 36828 CO Primary

Addresses

Primary practice location

1040 S 8TH Street
Suite 102
Colorado Springs, CO 80905

Mailing address

PO Box 7275
Woodland Park, CO 80863
Phone (719) 687-8752

Other identifiers 1

IdentifierTypeStateIssuer
01362821MedicaidCO

National Provider Directory

National Provider Directory

Locations

1040 S 8th St
Ste 102
Colorado Springs, CO 80905
Phone (719) 687-8752

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": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1396067310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7275",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "80863",
            "telephone_number": "719-687-8752",
            "fax_number": "719-687-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S 8TH STREET",
            "address_2": "SUITE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80905",
            "telephone_number": "719-687-8752",
            "fax_number": "719-687-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "EADS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "719-687-8752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01362821",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.