Organization Active NPI

Pinnacle Surgical Group, PC

  • Surgery Physician
  • Laramie, WY
National Provider Identifier
1831347095
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1040 (TEMPORARY) Issued in WY
Legal business name
PINNACLE SURGICAL GROUP, PC
Practice address
2710 Harney St
Suite 204
Laramie, WY 82072-2884
Phone
(307) 460-2055
Fax
(307) 460-2058
NPI assigned
Aug 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Rochelle Dawn Stark, M.D.
Title
M.D. / Owner
Phone
(307) 460-2055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 1040 (TEMPORARY) WY Primary

Addresses

Primary practice location

2710 Harney St
Suite 204
Laramie, WY 82072-2884

Mailing address

2710 Harney St
Suite 204
Laramie, WY 82072-2884
Phone (307) 460-2055

National Provider Directory

National Provider Directory

Locations

2710 Harney St
Ste 204
Laramie, WY 82072
Phone (307) 460-2055

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1831347095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 HARNEY ST",
            "address_2": "SUITE 204",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722884",
            "telephone_number": "307-460-2055",
            "fax_number": "307-460-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 HARNEY ST",
            "address_2": "SUITE 204",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722884",
            "telephone_number": "307-460-2055",
            "fax_number": "307-460-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE SURGICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "M.D. / OWNER",
        "authorized_official_telephone_number": "307-460-2055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WY",
            "license": "1040 (TEMPORARY)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.