| Pinnacle Family Practice, Llc | |
|
13135 Lee Jackson Memorial Hwy Ste 202 Fairfax VA 22033-1907 | |
| (703) 965-3168 | |
| (703) 000-0000 |
| Full Name | Pinnacle Family Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13135 Lee Jackson Memorial Hwy Ste 202, Fairfax, Virginia |
| Authorized Official Name and Position | Vanessa Billstone Peyton (PHYSICIAN OWNER) |
| Authorized Official Contact | 7039653168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinnacle Family Practice, Llc 13135 Lee Jackson Memorial Hwy Ste 202 Fairfax VA 22033-1907 Ph: (703) 965-3168 | Pinnacle Family Practice, Llc 13135 Lee Jackson Memorial Hwy Ste 202 Fairfax VA 22033-1907 Ph: (703) 965-3168 |
| NPI Number | 1255751228 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 04/17/2014 |
| Medicare PECOS PAC ID | 3779701727 |
|---|---|
| Medicare Enrollment ID | O20140904001292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255751228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101221501 (Virginia) | Primary |
| Provider Name | Vanessa B Peyton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851461446 PECOS PAC ID: 1557455136 Enrollment ID: I20070913000831 |
| Provider Name | Shubhra Saksena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891865473 PECOS PAC ID: 2961397203 Enrollment ID: I20070913000844 |
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