Healthcare Provider Details

I. General information

NPI: 1124961024
Provider Name (Legal Business Name): PINNACLE NEUROLOGICAL INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 DELMONICO DR STE 102
COLORADO SPRINGS CO
80919-2243
US

IV. Provider business mailing address

5825 DELMONICO DR STE 102
COLORADO SPRINGS CO
80919-2243
US

V. Phone/Fax

Practice location:
  • Phone: 719-715-4882
  • Fax: 303-381-1566
Mailing address:
  • Phone: 719-715-4882
  • Fax: 303-381-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY WAGNER
Title or Position: PRESIDENT PHYSICIAN
Credential:
Phone: 719-715-4882