CROSSROADS PHYSICIAN CORPORATION (NPI# 1629063698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629063698 |
| Entity Type | Organization |
| Organization Name | CROSSROADS PHYSICIAN CORPORATION |
| Practice Address |
1245 S Mill St Nashville IL 62263-2004 |
| Mailing Address |
7100 Commerce Way Suite 180 Brentwood TN 37027-2829 |
| Practice Telephone | 6183279333 |
| Practice Fax Number | 6183279022 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2009-04-27 |
| Authorized Official Name | DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 6154657626 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036052179 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184619033 | Crossroads Physician Corporation | Family Medicine | 205 E Belleville, Okawville, IL 62271 | 2005-09-16 |
| Street Address |
1245 S MILL ST |
| City | NASHVILLE |
| State | IL |
| Zip Code | 62263-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316555816 | Washington County Hospital District | Clinic/Center | 1245 S Mill St, Nashville, IL 62263-2004 | 2020-07-21 |
| 1003424011 | Washington County Hospital District | Family Medicine | 1245 S Mill St, Nashville, IL 62263-2004 | 2020-07-15 |
| 1760873616 | Msa Alliance, LLC Dba Pulmonary Physicians of Southern Illinois | Internal Medicine | 1245 S Mill St, Nashville, IL 62263-2004 | 2015-02-13 |
| 1184062093 | Msa Alliance, LLC | Surgery | 1245 S Mill St, Nashville, IL 62263-2004 | 2013-06-13 |
| 1174961270 | Oa Associates, LLC | Orthopaedic Surgery | 1245 S Mill St, Nashville, IL 62263-2004 | 2013-06-11 |
| 1104269091 | Msa Alliance, LLC | Surgery | 1245 S Mill St, Nashville, IL 62263-2004 | 2013-04-10 |
| 1699014407 | Ca Group, LLC | Internal Medicine | 1245 S Mill St, Nashville, IL 62263-2004 | 2013-02-14 |
| 1134440969 | Niraj Shah | Family Medicine | 1245 S Mill St, Nashville, IL 62263-2004 | 2010-06-16 |
| 1225023294 | Deborah L Auld | Physician Assistant | 1245 S Mill St, Pob 231, Nashville, IL 62263-2004 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518407998 | Betty Lou Birchett | Licensed Practical Nurse | 18429 Conservation Drive, Nashville, IL 62263 | 2017-03-03 |
| 1366740219 | Pamela S Lowry | Nurse Practitioner | 705 S. Grand Ave, Nashville, IL 62263 | 2011-03-02 |
| 1639364490 | Donna Trang Nguyen | Dentist | 520 East St Louis Street, Nashville, IL 62263 | 2007-09-13 |
| 1841297413 | Hyet Leslie Settlemoir | Internal Medicine | 705 S Grand St, Nashville, IL 62263 | 2005-06-28 |
| 1114205770 | Jennifer L Pennington | Physical Therapist | 3 Windswept Dr, Nashville, IL 62263 | 2011-08-01 |
| 1144296195 | Rodney Alan Small | Chiropractor | 1527 South Mill Street, Nashville, IL 62263-0027 | 2006-02-28 |
| 1891823662 | Washington County Vocational Workshop | Community/Behavioral Health | 781 E. Holzhauer Dr., Nashville, IL 62263-0273 | 2007-03-01 |
| 1457575243 | Developmental Management, Inc. | Nursing Facility/Intermediate Care Facility | 618 W Goodner St, Nashville, IL 62263-1009 | 2007-04-12 |
| 1144629718 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 618 W Goodner St, Nashville, IL 62263-1009 | 2014-08-19 |
| 1780734293 | County of Washington | Ambulance | 160 N West Court St, Nashville, IL 62263-1128 | 2007-01-10 |
| Find all providers in zip 62263 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671294 | Sarah Willms | Family Medicine | 2309 Crestmoor Rd Ste 200, Nashville, TN 37215-2043 | 2020-08-24 |
| 1346861309 | Rx Clinic LLC | Family Medicine | 1046 Mcgavock Pike Ste A, Nashville, TN 37217 | 2020-04-30 |
| 1831728054 | Sanitas Medical Center of Tennessee PC | Family Medicine | 2700 Gallatin Pike Ste A, Nashville, TN 37216-3702 | 2020-04-08 |
| 1851923817 | Tabitha Monique Ford | Family Medicine | 3926 Cross Creek Rd, Nashville, TN 37215-2403 | 2020-02-07 |
| 1235634023 | Jackson Primary Care | Family Medicine | 2010 Church St Ste 526, Nashville, TN 37203 | 2018-03-26 |
| 1942667761 | Harpeth Valley Health Center Pllc | Family Medicine | 213 Old Hickory Blvd, Nashville, TN 37221-1301 | 2016-01-25 |
| 1083001747 | Oyedotun Oyewole | Family Medicine | 1005 Dr D.b. Todd Jr Blvd, Nashville, TN 37208 | 2015-04-21 |
| 1922493576 | Monica A Stout | Family Medicine | 1500 21st Ave S Ste 3000, Nashville, TN 37212-3139 | 2015-03-31 |
| 1700213584 | Music City Medical Pllc | Family Medicine | 417 Welshwood Dr Ste 112, Nashville, TN 37211-4225 | 2013-10-11 |
| 1265869853 | Willie James Myers Jr. | Family Medicine | 2720 Clarksville Pike, Nashville, TN 37208-1259 | 2013-09-27 |
| Find all providers in NASHVILLE | ||||
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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.