Active NPI
Crossroads Hospice of Atlanta LLC
- Hospice and Palliative Medicine (Family Medicine) Physician
- Tucker, GA
National Provider Identifier
1487361812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician
- 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, 2022
- Organization subpart
- Yes
- Parent organization
- CARREFOUR ASSOCIATES, LLC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
- Crossroads Hospice & Palliative Care
National Provider Directory
National Provider DirectoryLocations
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.