Organization Active NPI

Pinnacle Internal Medicine PLLC

  • Internal Medicine Physician
  • Winchester, TN
National Provider Identifier
1942480801
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD26560 Issued in TN
Legal business name
PINNACLE INTERNAL MEDICINE PLLC
Practice address
1509 Old Cowan Rd
Winchester, TN 37398-1913
Phone
(931) 962-1004
Fax
(931) 962-1400
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Mr. Ephraim B Gammada, MDNPI 1174501027
Title
Owner
Phone
(931) 962-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD26560 TN Primary

Addresses

Primary practice location

1509 Old Cowan Rd
Winchester, TN 37398-1913

Mailing address

1509 Old Cowan Rd
Winchester, TN 37398-1913
Phone (931) 962-1004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080107000083 TN Part B Supplier - Clinic/Group Practice 9739279753 Receives reassigned benefits from 2 practitioners
Practice locations: Winchester, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0967173Pinnacle Internal Medicine1509 Old Cowan Road, Winchester, TN 37398Certificate of waiverNov 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1942480801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 OLD COWAN RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981913",
            "telephone_number": "931-962-1004",
            "fax_number": "931-962-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 OLD COWAN RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981913",
            "telephone_number": "931-962-1004",
            "fax_number": "931-962-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "GAMMADA",
        "authorized_official_first_name": "EPHRAIM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-962-1004",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD26560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.