Organization Active NPI

Pinnacle Health Concepts, LLC

  • Specialist
  • Boardman, OH
National Provider Identifier
1891825535
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10021 Issued in OH
Legal business name
PINNACLE HEALTH CONCEPTS, LLC
Practice address
755 Boardman Canfield Rd
BLDG F, Unit 2
Boardman, OH 44512-4300
Phone
(330) 480-9362
Fax
(330) 480-9407
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Jean A McConnell, PT
Title
President Owner
Phone
(330) 480-9362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 10021 OH Primary

Addresses

Primary practice location

755 Boardman Canfield Rd
BLDG F, Unit 2
Boardman, OH 44512-4300

Mailing address

755 Boardman Canfield Rd
BLDG F, Unit 2
Boardman, OH 44512-4300
Phone (330) 480-9362

Other identifiers 2

IdentifierTypeStateIssuer
2384647MedicaidOH
9336281OtherOHMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090401000001 OH Part B Supplier - Clinic/Group Practice 9739119272 Receives reassigned benefits from 1 practitioner
Practice locations: Boardman, OH

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Health Concepts2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1280 Boardman Canfield Rd
Ste 6
Boardman, OH 44512
Phone (330) 729-2135

755 Boardman Canfield Rd
Ste F2
Youngstown, OH 44512
Phone (330) 480-9362

Practitioners & affiliated clinicians

Practitioners 2

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": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1891825535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "BLDG F, UNIT 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-480-9362",
            "fax_number": "330-480-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "BLDG F, UNIT 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-480-9362",
            "fax_number": "330-480-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH CONCEPTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "330-480-9362",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "10021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2384647",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "9336281",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.