Individual provider Active NPI

Rita Jean Pink, MD

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1912007998
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301049902 Issued in MI
Practice address
3010 Trenwest Dr
Winston Salem, NC 27103-3208
Phone
(336) 718-5844
Fax
(336) 970-5298
NPI assigned
Sep 22, 2006
Last updated
Mar 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301049902 MI Primary

Addresses

Primary practice location

3010 Trenwest Dr
Winston Salem, NC 27103-3208

Mailing address

7210 N Main St
Suite 211
Clarkston, MI 48346-1575
Phone (248) 620-9199

Other identifiers 6

IdentifierTypeStateIssuer
2618606MedicaidMI
102389OtherMIGREAT LAKES HEALTH PLAN
300020943OtherMIRAILROAD MEDICARE
5905806MedicaidNC
1734923MedicaidMI
1734905MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25399NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Health Systems Corp. Past Accepting new patients
Triad Radiology Associates, PLLC Past Accepting new patients
Associated Radiologists of Oakland County PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1912007998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 N MAIN ST",
            "address_2": "SUITE 211",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461575",
            "telephone_number": "248-620-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "336-718-5844",
            "fax_number": "336-970-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINK",
        "first_name": "RITA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301049902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2618606",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "102389",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300020943",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905806",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1734923",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1734905",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.