NPIMap

Organization Active NPI

Pinnacle Pain Center, PS

  • Pain Medicine (Anesthesiology) Physician
  • Kennewick, WA
National Provider Identifier
1740434356
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PINNACLE PAIN CENTER, PS
Practice address
7401 W Hood Place
Suite 200
Kennewick, WA 99336-3400
Phone
(509) 591-0070
Fax
(509) 987-1977
NPI assigned
Nov 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Authorized official

Name
Ian Evans
Title
Ceo
Phone
(509) 578-8846

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

7401 W Hood Place
Suite 200
Kennewick, WA 99336-3400

Mailing address

8524 W Gage Blvd
BLDG a-1 Box 319
Kennewick, WA 99336-8241
Phone (509) 591-0070

Other identifiers 1

IdentifierTypeStateIssuer
1092681MedicaidWA

Other names 1

  • Lynx Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081219000476 WA Part B Supplier - Clinic/Group Practice 9032271309 Receives reassigned benefits from 13 practitioners
Practice locations: Kennewick, WA; Spokane Valley, WA

National Provider Directory

National Provider Directory

Locations

3864 Masthead St NE
Unit E2
Albuquerque, NM 87109

2700 Farmington Ave
Bldg G
Farmington, NM 87401
Phone (505) 208-6138

1050 Southgate
Pendleton, OR 97801
Phone (509) 591-0608

11 E H St
Ste F
Deer Park, WA 99006
Phone (509) 209-9474

317 Sanders Way
Goldendale, WA 98620
Phone (509) 773-4017

4303 W 24th Ave
#B2
Kennewick, WA 99338
Phone (509) 591-0608

8524 W Gage Blvd
Ste A1
Kennewick, WA 99336

3730 Plaza Way
Ste C6001
Kennewick, WA 99338
Phone (509) 591-0608

6825 Burden Blvd
#D2
Pasco, WA 99301
Phone (509) 591-0608

2460 Garlick Blvd
#B2
Richland, WA 99354
Phone (509) 591-0608

120 E Birch St
Walla Walla, WA 99362
Phone (509) 240-4179

6101 Summitview Ave
Ste 201
Yakima, WA 98908
Phone (509) 591-0608

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1740434356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 W GAGE BLVD",
            "address_2": "BLDG A-1 BOX 319",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368241",
            "telephone_number": "509-591-0070",
            "fax_number": "509-987-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 W HOOD PLACE",
            "address_2": "SUITE 200",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363400",
            "telephone_number": "509-591-0070",
            "fax_number": "509-987-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PAIN CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-578-8846"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092681",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynx Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lynx Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.