Organization Active NPI

Crossroads Hospice of Atlanta LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Tucker, GA
National Provider Identifier
1487361812
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
CROSSROADS HOSPICE OF ATLANTA LLC
Doing business as
Crossroads Hospice of Atlanta, LLC
Practice address
1957 Lakeside Pkwy Ste 300
Tucker, GA 30084-5881
Phone
(770) 270-9898
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CARREFOUR ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Clayton Lee Farmer
Title
Cfo/Coo
Phone
(918) 627-8446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X Primary

Addresses

Primary practice location

1957 Lakeside Pkwy Ste 300
Tucker, GA 30084-5881

Mailing address

10810 E 45TH St Ste 300
Tulsa, OK 74146-3816
Phone (918) 627-6846

Other names 2

  • Crossroads Hospice of Atlanta, LLC Doing business as
  • Crossroads Hospice & Palliative Care Other name

National Provider Directory

National Provider Directory

Locations

1957 Lakeside Pkwy
Ste 300
Tucker, GA 30084
Phone (770) 270-9898

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1487361812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 E 45TH ST STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463816",
            "telephone_number": "918-627-6846",
            "fax_number": "918-627-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 LAKESIDE PKWY STE 300",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845881",
            "telephone_number": "770-270-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS HOSPICE OF ATLANTA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARREFOUR ASSOCIATES, LLC",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "918-627-8446"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Hospice of Atlanta, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Hospice & Palliative Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.