MEDICARE: PINNACLE NEUROLOGICAL INSTITUTE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1124961024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE NEUROLOGICAL INSTITUTE LLC

Provider Business Mailing Address
First Line	:	5825 DELMONICO DR STE 102
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2243
Country	:	US
Telephone Number	:	719-715-4882
Fax Number	:	303-381-1566

Provider Business Practice Location Address
First Line	:	5825 DELMONICO DR STE 102
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2243
Country	:	US
Telephone Number	:	719-715-4882
Fax Number	:	303-381-1566

Authorized Official
Title or Position	:	PRESIDENT PHYSICIAN
Name	:	KIMBERLY WAGNER
Credential	:
Telephone Number	:	719-715-4882

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/20/2026

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