NPIMap

Organization Active NPI

Pinnacle Pediatrics and Internal Medicine Professional LLC

  • Primary Care Clinic/Center
  • Westminster, CO
National Provider Identifier
1871018085
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
53133 Issued in CO
Legal business name
PINNACLE PEDIATRICS AND INTERNAL MEDICINE PROFESSIONAL LLC
Practice address
13648 Orchard Pkwy Unit 900
Westminster, CO 80023-9263
Phone
(816) 590-9456
NPI assigned
Aug 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Walter Wilson
Title
Owner
Phone
(720) 223-6177

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Primary Care Clinic/Center 261QP2300X 53133 CO Primary

Addresses

Primary practice location

13648 Orchard Pkwy Unit 900
Westminster, CO 80023-9263

Mailing address

13648 Orchard Pkwy Unit 900
Westminster, CO 80023-9263
Phone (720) 239-7725

Other identifiers 1

IdentifierTypeStateIssuer
27727238MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181203000848 CO Part B Supplier - Clinic/Group Practice 5496099400 Receives reassigned benefits from 9 practitioners
Practice locations: Denver, CO; Westminster, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1502150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1871018085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13648 ORCHARD PKWY UNIT 900",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239263",
            "telephone_number": "720-239-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13648 ORCHARD PKWY UNIT 900",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239263",
            "telephone_number": "816-590-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PEDIATRICS AND INTERNAL MEDICINE PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-08",
        "last_updated": "2025-09-12",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-223-6177"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "53133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27727238",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.