NPIMap

Organization Active NPI

Crossroads Treatment Centers of Tennessee, P.C.

  • Multi-Specialty Clinic/Center
  • Oak Ridge, TN
National Provider Identifier
1194494526
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.
Practice address
110-112 Raleigh Rd.
Oak Ridge, TN 37830
Phone
(800) 805-6989
NPI assigned
Sep 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Authorized official

Name
Dr. Rupert James McCormac
Title
President
Phone
(864) 527-3145

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X Primary
Methadone Clinic 261QM2800X

Addresses

Primary practice location

110-112 Raleigh Rd.
Oak Ridge, TN 37830

Mailing address

200 E Broad St Ste 300
Greenville, SC 29601-2891
Phone (864) 527-3145

Other names 1

  • Crossroads Treatment Centers Oak Ridge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200213002831 TN Part B Supplier - Clinic/Group Practice 6204262025 Receives reassigned benefits from 45 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tullahoma, TN; Sparta, TN; Oak Ridge, TN; Newport, TN; Morristown, TN; Johnson City, TN; Knoxville, TN; Jacksboro, TN…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

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
44D2230559Crossroads Treatment Centers of Tennessee110-112 Raleigh Road, Oak Ridge, TN 37830Certificate of waiverJul 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Treatment Centers of Tennessee PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 Perkins Ln
Jacksboro, TN 37757
Phone (864) 436-7266

2001 Highland Ave
Knoxville, TN 37916
Phone (865) 633-0353

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1194494526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E BROAD ST STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012891",
            "telephone_number": "864-527-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-112 RALEIGH RD.",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "800-805-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "MCCORMAC",
        "authorized_official_first_name": "RUPERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-527-3145",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Treatment Centers Oak Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.