NPIMap

Organization Active NPI

Statesville Hma Medical Group, LLC

Doing business as Pinnacle Orthopedics

  • Orthopaedic Surgery Physician
  • Yadkinville, NC
National Provider Identifier
1942584990
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
STATESVILLE HMA MEDICAL GROUP, LLC
Doing business as
Pinnacle Orthopedics
Practice address
305 E Lee Ave
Yadkinville, NC 27055-8132
Phone
(336) 679-2661
Fax
(336) 679-7056
NPI assigned
Oct 7, 2011
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
STATESVILLE HMA MEDICAL GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Mrs. Jennifer L Jackson
Title
Sr Dir Prov Enrollment & Onboarding
Phone
(615) 465-3334

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Hand Surgery Physician 207XS0106X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

305 E Lee Ave
Yadkinville, NC 27055-8132

Mailing address

4000 Meridian Blvd
Franklin, TN 37067-6325
Phone (615) 465-7230

Other names 1

  • Pinnacle Orthopedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Statesville Hma Medical Group LLC15 organizations share this tax ID, including this one
Part of
Statesville Hma Medical Group LLC

Other organizations with this tax ID 14

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

View all 14

Locations

305 E Lee Ave
Yadkinville, NC 27055
Phone (336) 679-2661

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1942584990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558132",
            "telephone_number": "336-679-2661",
            "fax_number": "336-679-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESVILLE HMA MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATESVILLE HMA MEDICAL GROUP LLC",
        "enumeration_date": "2011-10-07",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pinnacle Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yadkinville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.