Healthcare Provider Details
I. General information
NPI: 1033824230
Provider Name (Legal Business Name): PINNACLE GASTROENTEROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2023
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 CUBA AVE
ALAMOGORDO NM
88310-5951
US
IV. Provider business mailing address
2076 CIELO BONITO
ALAMOGORDO NM
88310-7873
US
V. Phone/Fax
- Phone: 575-201-3280
- Fax:
- Phone: 203-430-5995
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUTH
RAWLINGS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 203-430-5995