Active NPI
Pinnacle Surgical Group, PC
- Surgery Physician
- Laramie, WY
National Provider Identifier
1831347095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 1040 (TEMPORARY)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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 DirectoryLocations
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.