CROSSROADS COMMUNITY SOURCE (NPI# 1083936157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083936157 |
| Entity Type | Organization |
| Organization Name | CROSSROADS COMMUNITY SOURCE |
| Practice Address |
1203 Ball St Perry GA 31069-2501 |
| Practice Telephone | 4789881294 |
| Practice Fax Number | 4789881193 |
| Mailing Telephone | 4789881294 |
| Mailing Fax Number | 4789881193 |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |
| Authorized Official Name | MR. WILLIAM C. DAVIS JR. (CEO) |
| Authorized Official Telephone | 4789881294 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | Agencies |
| Street Address |
1203 BALL ST |
| City | PERRY |
| State | GA |
| Zip Code | 31069-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386114924 | Rebecca Lyn Parker | Pharmacist | 302 Walton Chase, Perry, GA 31069 | 2018-11-27 |
| 1437637568 | Joshua Thomas Guley | Dentist | 2161 Houston Lake Road Hwy 127, Perry, GA 31069 | 2018-07-31 |
| 1043755531 | Otha Everett | Counselor | 733-b Carroll Street, Perry, GA 31069 | 2016-12-20 |
| 1699226001 | Middle Georgia Primary Care | Nurse Practitioner | 1115 Morningside Drive, Perry, GA 31069 | 2016-10-20 |
| 1639535628 | Holly Lavender | Nurse Practitioner | 1016 Keith Dr, Perry, GA 31069 | 2016-01-07 |
| 1598049918 | Spencer D Shugart | Physical Therapist | 1202 Macon Rd, Perry, GA 31069 | 2011-10-04 |
| 1154638518 | Middle Georgia Anesthesiology, LLC | Nurse Anesthetist, Certified Registered | 1040 Morningside Drive, Perry, GA 31069 | 2010-09-07 |
| 1922203686 | Sarah Pearson Velasquez | Nurse Practitioner | 1024 Keith Drive, Perry, GA 31069 | 2007-06-20 |
| 1417008004 | Bruce Duwayne Sampson | Internal Medicine | 1019 Keith Drive, Suite A, Perry, GA 31069 | 2007-01-12 |
| 1104839125 | Harold Brian Gillis | Chiropractor | 1207 Main Street Suite C, Perry, GA 31069 | 2006-08-14 |
| Find all providers in zip 31069 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295263168 | Sara K Shaw | Case Management | 555 N Byron Butler Pkwy, Perry, FL 32347-2315 | 2017-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902835 | Physicans At Home, LLC | Case Management | 1850 Blackwater Dr, Marietta, GA 30066-6712 | 2020-11-05 |
| 1699374934 | Primary Health Care Resource Service, Lp | Case Management | 5405 Memorial Dr Ste 101, Stone Mountain, GA 30083-3234 | 2020-10-19 |
| 1235736182 | Think Big Youth Organization LLC | Case Management | 9784 E Oglethorpe Hwy Ste C, Midway, GA 31320-4546 | 2020-10-05 |
| 1861008344 | Forever Home Care LLP | Case Management | 337 Oakview Way, Canton, GA 30114-1805 | 2020-09-20 |
| 1013523885 | Kingdom Expressions Atl LLC | Case Management | 101 W Campbellton St, Fairburn, GA 30213-1218 | 2020-09-17 |
| 1942814959 | The Evolve Center of Counseling & Coaching | Case Management | 8509 Dunwoody Pl, Atlanta, GA 30350-3330 | 2020-09-08 |
| 1245843671 | Talent Squad, LLC | Case Management | 4004 Castle Way, Fairburn, GA 30213-4712 | 2020-08-25 |
| 1477173706 | Patientory | Case Management | 3423 Piedmont Rd Ne Ste 373, Atlanta, GA 30305-1751 | 2020-04-16 |
| 1821626516 | Created2empower Counseling Services,llc | Case Management | 1001 Virginia Ave Ste 330, Atlanta, GA 30354-1367 | 2020-03-30 |
| 1245867795 | Melissa Carol Jenkins | Case Management | 154 Hill Rd, Lyons, GA 30436-4450 | 2020-03-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.