Organization Active NPI

Crossover Health Medical Group

  • Specialist
  • Charlotte, NC
National Provider Identifier
1346036571
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CROSSOVER HEALTH MEDICAL GROUP
Practice address
1515 S Tryon St FL 9
Charlotte, NC 28203-6816
Phone
(866) 271-3589
NPI assigned
Apr 15, 2025
Last updated
Apr 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Authorized official

Name
Mrs. Jenette Hunter, CPCS
Title
Sr. Manager Licensing, Credentialin
Phone
(971) 500-2661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1515 S Tryon St FL 9
Charlotte, NC 28203-6816

Mailing address

1515 S Tryon St FL 9
Charlotte, NC 28203-6816
Phone (866) 271-3589

Other identifiers 1

IdentifierTypeStateIssuer
193200000XOtherNON MEDICARE

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
34D2324087Crossover Health Medical Group, Apc1515 South Tryon Street, Floor 9, Charlotte, NC 28203Certificate of waiverMay 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Crossover Medical Group89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1515 S Tryon St
Fl 9
Charlotte, NC 28203

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1346036571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S TRYON ST FL 9",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036816",
            "telephone_number": "866-271-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S TRYON ST FL 9",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036816",
            "telephone_number": "866-271-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "JENETTE",
        "authorized_official_title_or_position": "SR. MANAGER LICENSING, CREDENTIALIN",
        "authorized_official_telephone_number": "971-500-2661",
        "authorized_official_name_prefix": "Mrs.",
        "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": "NON MEDICARE",
            "identifier": "193200000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.

Verify at the official NPI Registry.