Provider Demographics
NPI:1851335459
Name:CROSSWAY, INC.
Entity Type:Organization
Organization Name:CROSSWAY, INC.
Other - Org Name:CROSSWAY PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTD,OTR/L
Authorized Official - Phone:704-607-0014
Mailing Address - Street 1:9129 MONROE RD
Mailing Address - Street 2:SUITE 100-105
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-2429
Mailing Address - Country:US
Mailing Address - Phone:704-847-3911
Mailing Address - Fax:704-442-8724
Practice Address - Street 1:9129 MONROE RD
Practice Address - Street 2:SUITE 100-015
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-2429
Practice Address - Country:US
Practice Address - Phone:704-847-3911
Practice Address - Fax:704-847-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC183EEOtherBCBS INDIVIDUAL NUMBER
NC7211844Medicaid
NC017H3OtherGROUP NUMBER
NC7301435Medicaid
NCB0333OtherMEDCOST INDIVIDUAL NUMBER