Provider Demographics
NPI:1639579691
Name:CROSSROADS HEALTH GROUP, P.C.
Entity Type:Organization
Organization Name:CROSSROADS HEALTH GROUP, P.C.
Other - Org Name:RIPPA CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-323-1115
Mailing Address - Street 1:35 TURKEY HILL RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9031
Mailing Address - Country:US
Mailing Address - Phone:413-323-1115
Mailing Address - Fax:413-650-5548
Practice Address - Street 1:35 TURKEY HILL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9031
Practice Address - Country:US
Practice Address - Phone:413-323-1115
Practice Address - Fax:413-650-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3031111N00000X
MA9202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110074919AMedicaid
MAY45806Medicare PIN
MAS100298751Medicare PIN