Crossroads Surgical Assisting LLC

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

Legal business name

CROSSROADS SURGICAL ASSISTING LLC

Practice address

5473 Caribou Dr
Frederick, CO 80504-5813

Phone

(178) 525-9469

NPI assigned

May 11, 2021

Last updated

May 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa Lynn Haines, CNOR RNFANPI 1548841828

Title

First Assistant/Owner

Phone

(785) 259-4694

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Theresa Lynn Haines, CNOR RNFA

  • Registered Nurse First Assistant
  • Frederick, CO
  • NPI 1548841828
  NPD Authorized official

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1508440868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241",
            "city": "FREDERICK",
            "state": "CO",
            "postal_code": "805300241",
            "telephone_number": "785-259-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 CARIBOU DR",
            "city": "FREDERICK",
            "state": "CO",
            "postal_code": "805045813",
            "telephone_number": "178-525-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FIRST ASSISTANT/OWNER",
        "authorized_official_telephone_number": "785-259-4694",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNOR RNFA"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Derick Catbagan, PHARMD
• Catholic Health Initiatives Colorado (Centura Health Emergency and Urgent Care - Indian Peaks)
• Tara N Clemens, PA
• Shelby Lynn Coleman, PTA
• Kristina L Coonce, MA, LPC
• Michael Joseph Daly
• Erin Daugherty, LPCC
• Bryan Decker
• Dentists of Frederick, LLP
• Luis Felipe Diaz, RP

• Registered Nurse First Assistant in Frederick, CO
• Providers in Frederick, CO by specialty
• Registered Nurse First Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.