Provider Demographics
NPI:1740540772
Name:CROSSROADS URGENT CARE PLLC
Entity type:Organization
Organization Name:CROSSROADS URGENT CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:615-988-2012
Mailing Address - Street 1:30 BURTON HILLS BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6183
Mailing Address - Country:US
Mailing Address - Phone:615-988-2000
Mailing Address - Fax:615-891-1668
Practice Address - Street 1:10644 CONCORD ROAD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8811
Practice Address - Country:US
Practice Address - Phone:615-941-8768
Practice Address - Fax:615-941-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care