Samuel Ray Cross

Primary specialty

DentistTaxonomy code 122300000X

License

4625 Issued in NC

Practice address

401 Doctor's Circle
Elizabethtown, NC 28337

Phone

(910) 862-2892

NPI assigned

Jan 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samuel Ray Cross DDS PA

  • Dentist
  • Elizabethtown, NC
  • NPI 1467566018
  NPD (past) Authorized official
• Justin M Degarmo DMD & Ann Hamill Greene DDS PA

  • Dentist
  • Elizabethtown, NC
  • NPI 1982124681
  NPD (past)

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1174700967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DOCTOR'S CIRCLE",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DOCTOR'S CIRCLE",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "SAMUEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "4625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8991904",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91904",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U37843",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Bladen Office of Auditor (Bladen County Home Health Agency)
• County of Bladen Office of Auditor (Bladen County Health Department)
• County of Bladen Office of Auditor (Bladen County Emergency Medical Services)
• County of Bladen Office of Auditor (Bladen County Health Department)
• Cromartie Enterprise LLC
• Cumberland County Hospital System Inc (CFV Foot and Ankle Center)
• Evelyn Rene Delieto, MA, CCC-SLP
• Jackie G Dennis, RN
• Toni H. Devane, RDN
• Breana Zhane Danielle Dickens, LCSWA

• Dentist in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.