Cross Lake Emergency Group, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CROSS LAKE EMERGENCY GROUP, LLC

Practice address

2600 Greenwood Rd
Shreveport, LA 71103-3908

Phone

(318) 212-4000

NPI assigned

Aug 17, 2018

Last updated

Mar 23, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisha C Falk

Title

VP of Contracting

Phone

(337) 609-1221

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 134

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Craig Andrews, M.D.

  • Emergency Medicine Physician
  • Baton Rouge, LA
  • NPI 1639495385
  Medicare reassignment Care Compare group NPD
• Bryant Boyd, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1437440450
  Medicare reassignment Care Compare group NPD
• Dalton Robert Carroll, FNP-C

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1376115212
  Medicare reassignment Care Compare group NPD
• Kimberly Clark, NP

  • Family Nurse Practitioner
  • Denham Springs, LA
  • NPI 1780037994
  Medicare reassignment Care Compare group NPD
• Tyler Randall Davis, MD

  • Emergency Medicine Physician
  • Monroe, LA
  • NPI 1972064160
  Medicare reassignment Care Compare group NPD
• Joseph A Farquhar, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1922000348
  Medicare reassignment Care Compare group NPD
• Craig Florea, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1053368258
  Medicare reassignment Care Compare group NPD
• Kelli Irvin Harris, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1770089518

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Andrew T Haynes, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1902847569
  Medicare reassignment Care Compare group NPD
• Travis Headley, MD

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1982847414
  Medicare reassignment Care Compare group NPD
• Steven E Holt, MD

  • Emergency Medicine Physician
  • Bossier City, LA
  • NPI 1578549622
  Medicare reassignment Care Compare group NPD
• John J Horan, MD

  • Emergency Medicine Physician
  • Bossier City, LA
  • NPI 1528044377
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1013497114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033908",
            "telephone_number": "318-212-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 Youree Dr",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711152302",
            "country_code": "US",
            "telephone_number": "318-212-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112385",
            "country_code": "US",
            "telephone_number": "318-212-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2510 Bert Kouns Industrial Loop",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711183119",
            "country_code": "US",
            "telephone_number": "318-212-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CROSS LAKE EMERGENCY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "LISHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP OF CONTRACTING",
        "authorized_official_telephone_number": "337-609-1221"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2482726",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laquanisha Crockett
• Felicia Annette Croft, ACNPC-AG
• Jonaya Cromwell
• Machelle Lee Crooks, PTA
• Bethany Cubley Crosby, PA
• Erin Crouch, PHARM.D.
• Rhonda J. Crouch, NP
• Stacie R Crouch, M.A, LPC, LMFT
• Candice Crow
• Jennifer L Crow, LPC

• Emergency Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.