Organization Active NPI

Crossroads Clinic Volunteers in Medicine

  • General Practice Physician
  • Lake St Louis, MO
National Provider Identifier
1053117598
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CROSSROADS CLINIC VOLUNTEERS IN MEDICINE
Practice address
10890 Veterans Memorial Parkway
Lake St. Louis, MO 63367
Phone
(636) 561-3133
Fax
(636) 625-3534
NPI assigned
Feb 24, 2025
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Maimuna Baig, M.D.
Title
Medical Director
Phone
(636) 561-3133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

10890 Veterans Memorial Parkway
Lake St. Louis, MO 63367

Mailing address

10890 Veterans Memorial Parkway
Lake St. Louis, MO 63367
Phone (636) 561-3133

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1053117598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10890 VETERANS MEMORIAL PARKWAY",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-561-3133",
            "fax_number": "636-625-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10890 VETERANS MEMORIAL PARKWAY",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-561-3133",
            "fax_number": "636-625-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS CLINIC VOLUNTEERS IN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "BAIG",
        "authorized_official_first_name": "MAIMUNA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "636-561-3133",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.