Provider Demographics
NPI:1326000597
Name:PINNACLE MEDICINE INC.
Entity Type:Organization
Organization Name:PINNACLE MEDICINE INC.
Other - Org Name:NEXTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUFELDT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:480-924-8382
Mailing Address - Street 1:PO BOX 21660
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-1660
Mailing Address - Country:US
Mailing Address - Phone:480-924-8382
Mailing Address - Fax:480-776-1605
Practice Address - Street 1:1066 N POWER RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-5709
Practice Address - Country:US
Practice Address - Phone:480-776-1588
Practice Address - Fax:480-807-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC3374261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ156853Medicaid
AZCF8266OtherRAILROAD MEDICARE POWER
AZCR0446OtherRAILROAD MEDICARE PIMA
AZCR0446OtherRAILROAD MEDICARE PIMA
AZWCKLJMedicare ID - Type Unspecified