NPIMap

Organization Active NPI

Pinnacle Treatment Centers VA-I, LLC

Doing business as FCCR Radford

  • Methadone Clinic
  • Richmond, VA
National Provider Identifier
1750872966
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PINNACLE TREATMENT CENTERS VA-I, LLC
Doing business as
FCCR Radford
Practice address
4906 Radford Ave
Richmond, VA 23230-3512
Phone
(804) 354-1996
NPI assigned
May 23, 2018
Last updated
Nov 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Recovery Care Clinic/Center 261QR0800X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

4906 Radford Ave
Richmond, VA 23230-3512

Mailing address

1317 Route 73
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111

Other names 1

  • FCCR Radford Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130000451 VA Part B Supplier - Opioid Treatment Program (Otp) 1951737568 3 other NPIs on this enrollment
Practice locations: Fredericksburg, VA; Front Royal, VA; North Chesterfield, VA; Richmond, VA

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2138129Pinnacle Treatment Centers VA-I LLC,4906 Radford Avenue, Richmond, VA 23230Certificate of waiverOct 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
FCCR Radford4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1750872966",
    "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": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 RADFORD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303512",
            "telephone_number": "804-354-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS VA-I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "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": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCCR Radford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • 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.