Organization Active NPI

Crossroads Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Brentwood, TN
National Provider Identifier
1174679054
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CROSSROADS SURGERY CENTER, LLC
Practice address
1805 Williamson CT
Suite 200
Brentwood, TN 37027-7974
Phone
(615) 613-0259
Fax
(615) 548-2952
NPI assigned
Jan 25, 2007
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Mr. Rodney H Lunn Sr.
Title
Owner
Phone
(615) 602-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

1805 Williamson CT
Suite 200
Brentwood, TN 37027-7974

Mailing address

1805 Williamson CT
Suite 200
Brentwood, TN 37027-7974
Phone (615) 331-5536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070703000325 TN Part B Supplier - Ambulatory Surgical Center 1052411105 Receives reassigned benefits from 1 practitioner
Practice locations: Brentwood, TN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Crossroads Surgery CenterCCN 44C0001189
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1065557Crossroads Surgery Center LLC1805 Williamson Court Suite #200, Brentwood, TN 37027Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory

Locations

1805 Williamson Ct
Ste 200
Brentwood, TN 37027
Phone (615) 331-5536

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1174679054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 WILLIAMSON CT",
            "address_2": "SUITE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277974",
            "telephone_number": "615-331-5536",
            "fax_number": "615-331-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 WILLIAMSON CT",
            "address_2": "SUITE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277974",
            "telephone_number": "615-613-0259",
            "fax_number": "615-548-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "LUNN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-602-9300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.