Individual provider Active NPI

Ebony Joi Cross, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1508303801
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R221761 Issued in MD
Practice address
2670 Crain Hwy Ste 510
Waldorf, MD 20601-2819
Phone
(301) 374-8772
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R221761 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R221761 MD Primary

Addresses

Primary practice location

2670 Crain Hwy Ste 510
Waldorf, MD 20601-2819

Mailing address

2670 Crain Hwy Ste 510
Waldorf, MD 20601-2819

Other practice location 1

2670 Crain Hwy Ste 501
Waldorf, MD 20601-2819
Phone (301) 374-8772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170803000024 DC Practitioner - Nurse Practitioner 2264703644 Reassigns benefits to 1 organization
I20200908000063 MD Practitioner - Nurse Practitioner 2264703644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cross Behavioral ConsultingGroup PAC ID 8123445194, 5 clinicians

Practice addresses (Care Compare)

2670 Crain Hwy
Suite 106
Waldorf, MD 20601-2820
Phone (301) 374-8772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R221761MDMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Affiliates LLC Psychiatric/Mental Health Current Accepting new patients
Cross Behavioral Consulting LLC Past Accepting new patients
Cross Behavioral Consulting LLC Past Accepting new patients
Cross Behavioral Consulting LLC Past Accepting new patients

Locations

2670 Crain Hwy
Ste 510
Waldorf, MD 20601
Phone (301) 374-8772

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1508303801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 CRAIN HWY STE 510",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 CRAIN HWY STE 510",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012819",
            "telephone_number": "301-374-8772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2670 Crain Hwy Ste 501",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206012819",
            "country_code": "US",
            "telephone_number": "301-374-8772",
            "fax_number": "301-374-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSS",
        "first_name": "EBONY",
        "middle_name": "JOI",
        "name_prefix": "Ms.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R221761",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R221761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.