NPIMap

Organization Active NPI

Crossroads Treatment Centers of Tennessee, P.C.

  • Clinical Medical Laboratory
  • Johnson City, TN
National Provider Identifier
1285599431
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.
Practice address
3114 Browns Mill Rd
Johnson City, TN 37604-1417
Phone
(800) 805-6989
Fax
(864) 558-8511
NPI assigned
Dec 19, 2025
Last updated
Jan 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Rupert McCormac IVNPI 1669486239
Title
Chief Executive Officer
Phone
(800) 805-6989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

3114 Browns Mill Rd
Johnson City, TN 37604-1417

Mailing address

PO Box 749057
Atlanta, GA 30374-9057
Phone (800) 805-6989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260424002695 TN Part B Supplier - Independent Clinical Laboratory 6204262025 Practice locations: Johnson City, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
44D2158347Crossroads Treatment Centers of Tennessee, PC3114 Browns Mill Road, Johnson City, TN 37604ComplianceJan 3, 2028

National Provider Directory

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

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1766102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1285599431",
    "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": "864-558-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 BROWNS MILL RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041417",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.",
        "enumeration_date": "2025-12-19",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "MCCORMAC",
        "authorized_official_first_name": "RUPERT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "800-805-6989",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.