Active NPI
Crossover Health Medical Group
- Specialist
- Louisville, KY
National Provider Identifier
1184437550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- CROSSOVER HEALTH MEDICAL GROUP
- Practice address
- 1169 Eastern Pkwy Ste 200
Louisville, KY 40217-1413 - Phone
- (971) 500-2661
- NPI assigned
- Jan 29, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jenette Hunter, CPCS
- Title
- Licensing and Credentialing Manager
- Phone
- (971) 500-2661
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1169 Eastern Pkwy Ste 200
Louisville, KY 40217-1413
Mailing address
1169 Eastern Pkwy Ste 200
Louisville, KY 40217-1413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193200000X | Other | MULTI SPECIALTY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2206490 | Crossover Health Medical Group, Apc | Certificate of waiver | Dec 20, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Crossover Medical Group
Organizations with this tax ID in the same state 3
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Specialist
- Covington, KY
- NPI 1285495515
-
dba Crossover @ Ridge Park
- Multi-Specialty Clinic/Center
- Louisville, KY
- NPI 1548877491
-
dba Crossover @ Shepherdsville
- Multi-Specialty Clinic/Center
- Shepherdsville, KY
- NPI 1992312847
Locations
1169 Eastern Pkwy
Ste 200
Louisville, KY 40217
Phone (502) 425-7659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738108800000",
"number": "1184437550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1169 EASTERN PKWY STE 200",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 EASTERN PKWY STE 200",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171413",
"telephone_number": "971-500-2661"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A",
"authorized_official_last_name": "HUNTER",
"authorized_official_first_name": "JENETTE",
"authorized_official_title_or_position": "LICENSING AND CREDENTIALING MANAGER",
"authorized_official_telephone_number": "971-500-2661",
"authorized_official_credential": "CPCS"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTI SPECIALTY",
"identifier": "193200000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.