Crossroads Treatment Centers | |
301 Falls Dr Nw Ste 353 Abingdon VA 24210-8093 | |
(800) 805-6989 | |
(864) 558-8511 |
Full Name | Crossroads Treatment Centers |
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Speciality | Clinic/Center |
Location | 301 Falls Dr Nw Ste 353, Abingdon, Virginia |
Authorized Official Name and Position | Rupert Mccormac (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8008056989 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Crossroads Treatment Centers Po Box 749057 Atlanta GA 30374-9057 Ph: (800) 805-6989 | Crossroads Treatment Centers 301 Falls Dr Nw Ste 353 Abingdon VA 24210-8093 Ph: (800) 805-6989 |
NPI Number | 1760949127 |
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Provider Enumeration Date | 02/21/2019 |
Last Update Date | 08/13/2024 |
Certification Date | 08/13/2024 |
Medicare PECOS PAC ID | 9931535820 |
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Medicare Enrollment ID | O20200213000787 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760949127 | NPI | - | NPPES |
Provider Name | Brian L Maggard |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1922051705 PECOS PAC ID: 7517854581 Enrollment ID: I20040303000838 |
Provider Name | Zelda West Johnson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801933007 PECOS PAC ID: 1153310073 Enrollment ID: I20040506001747 |
Provider Name | Michael G Waters |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417915547 PECOS PAC ID: 2860417508 Enrollment ID: I20051011001022 |
Provider Name | Holly Ann Johnson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033221379 PECOS PAC ID: 3971524174 Enrollment ID: I20051215000525 |
Provider Name | Meenakshi Gopal |
---|---|
Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1003861915 PECOS PAC ID: 7012998172 Enrollment ID: I20061003000416 |
Provider Name | Shazia Habib Farooqi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770699613 PECOS PAC ID: 7911001763 Enrollment ID: I20070403000607 |
Provider Name | Ronald L Schubert |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982670493 PECOS PAC ID: 2567537087 Enrollment ID: I20080819000242 |
Provider Name | Robert N Lowe |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1134158470 PECOS PAC ID: 9739249152 Enrollment ID: I20081114000621 |
Provider Name | Henry Vega |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1619088424 PECOS PAC ID: 5092733253 Enrollment ID: I20090302000612 |
Provider Name | Dante G Richardson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922157106 PECOS PAC ID: 6800934035 Enrollment ID: I20100203000891 |
Provider Name | Ramona Boyd |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871815316 PECOS PAC ID: 1557556537 Enrollment ID: I20101116000957 |
Provider Name | Sheree Savage-artis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841665163 PECOS PAC ID: 2264739879 Enrollment ID: I20160328000221 |
Provider Name | Alta Deroo |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184791725 PECOS PAC ID: 7618150152 Enrollment ID: I20160701001269 |
Provider Name | Denny R Goss |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1235573478 PECOS PAC ID: 0648591487 Enrollment ID: I20160713000062 |
Provider Name | Shay K Mitchell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649593948 PECOS PAC ID: 1850573882 Enrollment ID: I20160720001669 |
Provider Name | Angel M Williams-kent |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598219214 PECOS PAC ID: 2961782859 Enrollment ID: I20161212001414 |
Provider Name | Wallisa T Vaughn |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992990238 PECOS PAC ID: 7618021502 Enrollment ID: I20170918002301 |
Provider Name | Mark W Mossey |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1841228863 PECOS PAC ID: 6507894367 Enrollment ID: I20171010001213 |
Provider Name | Rebekah P Peery |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144536509 PECOS PAC ID: 2062769888 Enrollment ID: I20180724003130 |
Provider Name | Katherine Hilsinger |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1871584631 PECOS PAC ID: 0840180378 Enrollment ID: I20180919003142 |
Provider Name | William B Wolf |
---|---|
Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1316262124 PECOS PAC ID: 7012968522 Enrollment ID: I20190212001858 |
Provider Name | Cynthia Davis Barker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982174900 PECOS PAC ID: 7416295316 Enrollment ID: I20190220000189 |
Provider Name | Tayler B Kerns |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467921601 PECOS PAC ID: 6901147495 Enrollment ID: I20190410001642 |
Provider Name | Amanda C Higgs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861901506 PECOS PAC ID: 5294169785 Enrollment ID: I20191216001165 |
Provider Name | Evelyne Kingori |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821650177 PECOS PAC ID: 9032544101 Enrollment ID: I20200203000255 |
Provider Name | Viet H Nguyen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881124378 PECOS PAC ID: 1355614025 Enrollment ID: I20200213000684 |
Provider Name | Claudia Jean White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831355759 PECOS PAC ID: 9436585320 Enrollment ID: I20200213001040 |
Provider Name | Mehran Bajoghli |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699868786 PECOS PAC ID: 5698749737 Enrollment ID: I20200214001352 |
Provider Name | Seth Clayton Thompson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467683300 PECOS PAC ID: 6507164506 Enrollment ID: I20200214001634 |
Provider Name | Emmaleona Ego Agogbua |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083277784 PECOS PAC ID: 0840629408 Enrollment ID: I20200406003453 |
Provider Name | Nnemdi Kamanu Elias |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538369830 PECOS PAC ID: 5395046122 Enrollment ID: I20200408003958 |
Provider Name | Kimberly Olinger |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669825410 PECOS PAC ID: 5991135014 Enrollment ID: I20200413003423 |
Provider Name | Linwood Turner |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730398330 PECOS PAC ID: 4284969049 Enrollment ID: I20200518003204 |
Provider Name | Katrina D Edwards |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922519693 PECOS PAC ID: 9638438567 Enrollment ID: I20200921001895 |
Provider Name | Cameron A Brown |
---|---|
Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1932484490 PECOS PAC ID: 5991039323 Enrollment ID: I20201007000904 |
Provider Name | Amanda K Whitley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467070342 PECOS PAC ID: 4284663923 Enrollment ID: I20210211002307 |
Provider Name | Gelila Tesfaye |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407404452 PECOS PAC ID: 8022426741 Enrollment ID: I20210419002083 |
Provider Name | Elizabeth K Villafane-sparks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033881834 PECOS PAC ID: 8628462967 Enrollment ID: I20220302000464 |
Provider Name | Sheri Kena Yarber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639817083 PECOS PAC ID: 6709261670 Enrollment ID: I20220913001061 |
Provider Name | Ray Anthony Mercado |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1275606030 PECOS PAC ID: 6305960337 Enrollment ID: I20221108002768 |
Provider Name | Mellissa Potter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922683036 PECOS PAC ID: 6103295282 Enrollment ID: I20221212002551 |
Provider Name | Marcia Anne Fairbanks |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992437008 PECOS PAC ID: 2365816451 Enrollment ID: I20230313000178 |
Provider Name | Jennifer Lynn Estep |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1548906183 PECOS PAC ID: 9436590015 Enrollment ID: I20240514001819 |
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