Crossroads Treatment Center of Charleston, PC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CROSSROADS TREATMENT CENTER OF CHARLESTON, PC

Practice address

2470 Mall Dr Unit BCD
North Charleston, SC 29406-6514

Phone

(843) 207-4721

NPI assigned

Nov 21, 2016

Last updated

Sep 3, 2024By 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

Dr. Rupert J. McCormac IV, MDNPI 1669486239

Title

Ceo

Phone

(800) 805-6989

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 14

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.

• Rupert James McCormac IV, M.D.

  • Psychiatry Physician
  • Greer, SC
  • NPI 1669486239
  Authorized official Same address or phone
• Ashley Buntura, NP

  • Nurse Practitioner
  • Conway, SC
  • NPI 1871106955
  NPD
• Amber Star Green, APRN

  • Nurse Practitioner
  • West Columbia, SC
  • NPI 1205987047
  NPD
• Joshua Andrew Hall, D.O.

  • Addiction Medicine (Family Medicine) Physician
  • Spartanburg, SC
  • NPI 1497135503
  NPD
• John A Pfeiffer, MD

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1578537221
  NPD
• William Keith Queen, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Florence, SC
  • NPI 1437807120
  NPD
• Veronica Ridpath, D.O.

  • Psychiatry Physician
  • Florence, SC
  • NPI 1851825780
  NPD
• Robert Clifton Glenn, MD

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1902033210
  NPD
• Alexandra Joy McQuaid, M.D

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1427679737
  NPD
• James P Stephen, MD

  • General Practice Physician
  • Buffalo, NY
  • NPI 1821009911
  NPD
• Latrera Campbell Woodberry, FNP

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1679037444
  NPD
• McCrae Paxton Carroll, MA, LPC

  • Professional Counselor
  • Goose Creek, SC
  • NPI 1679123384
  NPD (past)

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1114460375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749057",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749057",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 MALL DR UNIT BCD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066514",
            "telephone_number": "843-207-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTER OF CHARLESTON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "MCCORMAC",
        "authorized_official_first_name": "RUPERT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-805-6989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crevar Chiropractic
• Blaine M Crevar, D.C.
• Anna Crews, BCABA
• Courtney Brooke Cristler, DPT
• Nancy Elizabeth Crossley, M.D.
• Scott Crothers, ATC
• Stephanie Crow
• Crowfield at North Charleston, LLC
• Elizabeth Crutchfield
• Sierra Culbreath

• Substance Use Disorder Rehabilitation Clinic/Center in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.