NPIMap

Organization Active NPI

Crossover Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
National Provider Identifier
1407297963
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CROSSOVER HEALTH SERVICES INC
Practice address
940 E 36TH St N
Tulsa, OK 74106-1953
Phone
(918) 398-9460
Fax
(918) 398-9460
NPI assigned
Jul 12, 2013
Last updated
Mar 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Mrs. Sharmien Charnisette Watkins
Title
Cfo
Phone
(918) 398-9460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 14202 OK
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

940 E 36TH St N
Tulsa, OK 74106-1953

Mailing address

940 E 36TH St N
Tulsa, OK 74106-1953
Phone (918) 398-9460

Other identifiers 2

IdentifierTypeStateIssuer
200514040AMedicaidOK
100089530CMedicaidOK

Other names 2

  • CROSSOVER COMMUNITY IMPACT, INC Former legal business name
  • Crossover Health Services, L.L.C. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140828000563 OK Part B Supplier - Clinic/Group Practice 0345468625 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Tulsa, OK
O20240319004043 OK Part B Supplier - Clinic/Group Practice 2668819145 Receives reassigned benefits from 6 practitioners
Practice locations: Tulsa, OK
O20241218000607 OK Part A Provider - Federally Qualified Health Center (FQHC) 2668819145 Practice locations: Tulsa, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407297963. Details of each certification follow.

Federally qualified health center certification: CCN 371043

Legal name
CROSSOVER HEALTH SERVICES INC
Doing business as
REALTIME, LLC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2024
Last certification
Dec 10, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
940 E 36TH St N
Tulsa, OK 74106-1953

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

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
37D2090121Crossover Health Services, Inc940 E 36TH St North, Tulsa, OK 74106Certificate of waiverJan 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
CHS at 36TH Street Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

940 E 36th St N
Tulsa, OK 74106
Phone (918) 398-9460

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16190/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sharmien Charnisette Watkins Individual W-2 Managing EmployeeChief Financial Officer Aug 1, 2023 33%
Robin Higgins Individual Corporate OfficerBoard Treasurer Aug 1, 2023
Eva Louise Ingram Individual Corporate OfficerBoard Vice President Aug 1, 2023
Natalie K Schaller Individual W-2 Managing EmployeeCmo Aug 1, 2023
John T Whitaker Individual W-2 Managing EmployeeCeo Aug 1, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1407297963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E 36TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061953",
            "telephone_number": "918-398-9460",
            "fax_number": "918-398-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E 36TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061953",
            "telephone_number": "918-398-9460",
            "fax_number": "918-398-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "SHARMIEN",
        "authorized_official_middle_name": "CHARNISETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "918-398-9460",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "14202",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200514040A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089530C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CROSSOVER COMMUNITY IMPACT, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Crossover Health Services, L.L.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.