NPIMap

Organization Active NPI

Pinnacle Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Keizer, OR
National Provider Identifier
1760675615
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
4634 Issued in OR
Legal business name
PINNACLE PHYSICAL THERAPY PC
Practice address
4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone
(503) 390-9009
Fax
(503) 393-0834
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Bobby Ismail
Title
Ceo
Phone
(209) 576-0710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 4634 OR Primary

Addresses

Primary practice location

4025 Cherry Ave NE
Keizer, OR 97303-4859

Mailing address

4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone (503) 390-9009

National Provider Directory

National Provider Directory

Locations

4630 River Rd N
Ste B
Keizer, OR 97303
Phone (503) 390-9009

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 3

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": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1760675615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009",
            "fax_number": "503-393-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009",
            "fax_number": "503-393-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-576-0710"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.