Crossroads Physicians Corp
Organization Active NPI Family Medicine Physician · Mount Vernon, IL
NPI 1508850520 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1508850520
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CROSSROADS PHYSICIANS CORP
- Practice address
- 209 Crossroads PL
Suite 110
Mount Vernon, IL 62864-6254 - Phone
- (618) 244-6710
- Fax
- (618) 244-6779
- NPI assigned
- Sep 6, 2005
- Organization subpart
- No
Authorized official
- Name
- Laura J Fey
- Title
- Sr. Director Physician Rev Cycle
- Phone
- (615) 221-3641
Practitioners 33
-
Deborah L Auld, PA-C
-
Rene L Bernard, FNP
-
Elizabeth D Cox, MD
-
Mike S Davenport, FNP
-
Lisa K Feather, PA-C
-
Bindu Finnell, MD
-
Kristen Jacobs, MD
-
Andrew Robert Johnson, M.D.
-
Kirandeep Khangura, MBBS
-
Julie A Lampley-Douglass, PA-C
-
David J Lane, AU.D., CCC-A
-
Shirley Moody, PA
-
Robert Parks, M.D.
-
Mary K Piper, FNP
-
Angel L Rector, APRN,BC
-
Amy Jayne Stevens, PA-C
-
Sandra Tate, APN, PMNCNS-BC
-
Lee Peter Bee, D.O., F.A.C.O.I.
-
Tiffany Lynn Brown, PA-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Surgery Physician |
208600000X | |||
| Urology Physician |
208800000X | |||
| Rural Health Clinic/Center | 261QR1300X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
209 Crossroads PL
Suite 110
Mount Vernon, IL 62864-6254
Mailing address
1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone (152) 221-1400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036064567 | Medicaid | IL | |
| 4132020 | Other | IL | BCBS IL |
Other providers in Mount Vernon, IL
- Crossroads Physician Corp
- Crossroads Physician Corp
- Crossroads Physician Corp
- Crossroads Physician Corp
- Crossroads Physician Corp
- Ryan Crouse
- Gabrielle Cultice
- Twana Sue Curry
- Danna Kathleen Dailey
- Merenda L Dale
All providers in Mount Vernon, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.