NPIMap

Organization Active NPI

Crossroads Treatment Center of Northwest Georgia

  • Community/Behavioral Health Agency
  • Ringgold, GA
National Provider Identifier
1356799688
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CROSSROADS TREATMENT CENTER OF NORTHWEST GEORGIA
Doing business as
Crossroads Treatment Center of Northwest Georgia
Practice address
4083 Cloud Springs Rd
Ringgold, GA 30736
Phone
(800) 805-6989
Fax
(864) 558-8511
NPI assigned
May 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Rupert James McCormac
Title
President
Phone
(800) 805-6989

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X GA-10131-M GA
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X
Methadone Clinic 261QM2800X
Primary Care Clinic/Center 261QP2300X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4083 Cloud Springs Rd
Ringgold, GA 30736

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
NTP001064OtherGASTATE LICENSE

Other names 1

  • Crossroads Treatment Center of Northwest Georgia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200221002142 GA Part B Supplier - Opioid Treatment Program (Otp) 0345677837 Practice locations: Ringgold, GA

National Provider Directory

National Provider Directory

Locations

4083 Cloud Springs Rd
Ringgold, GA 30736
Phone (706) 820-6087

Practitioners & affiliated clinicians

Practitioners 12

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": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1356799688",
    "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": "4083 CLOUD SPRINGS RD",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "30736",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTER OF NORTHWEST GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "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": "800-805-6989"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "GA-10131-M",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NTP001064",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Treatment Center of Northwest Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.