Provider Demographics
NPI:1770699456
Name:PINNACLE HAND THERAPY LLC
Entity type:Organization
Organization Name:PINNACLE HAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-595-4880
Mailing Address - Street 1:704 CITY CENTER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3094
Mailing Address - Country:US
Mailing Address - Phone:757-880-6675
Mailing Address - Fax:757-595-4886
Practice Address - Street 1:704 MIDDLE GROUND BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4526
Practice Address - Country:US
Practice Address - Phone:757-595-4880
Practice Address - Fax:757-595-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000085225X00000X, 335E00000X, 225XH1200X
VA0119002028225XH1200X, 225XN1300X, 225XP0200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010029171Medicaid
VA008948721Medicaid
VA00V150P73Medicare PIN
VA010029171Medicaid
VA008948721Medicaid