NPIMap

Organization Active NPI

Crossroads Wellness Group, LLC

  • Chiropractor
  • Fort Lauderdale, FL
National Provider Identifier
1538675004
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10147 Issued in FL
Legal business name
CROSSROADS WELLNESS GROUP, LLC
Practice address
4200 SW 54TH CT
Fort Lauderdale, FL 33314-6726
Phone
(954) 999-3458
NPI assigned
Dec 20, 2017
Last updated
Oct 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Authorized official

Name
Dr. Jason Lucas, DCNPI 1922249556
Title
Owner
Phone
(954) 999-3458

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Chiropractor 111N00000X CH10147 FL Primary

Addresses

Primary practice location

4200 SW 54TH CT
Fort Lauderdale, FL 33314-6726

Mailing address

11571 NW 20TH CT
Plantation, FL 33323-2007

Other practice location 1

11571 NW 20th Ct
Plantation, FL 33323
Phone (954) 999-3661

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1538675004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11571 NW 20TH CT",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SW 54TH CT",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333146726",
            "telephone_number": "954-999-3458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11571 NW 20th Ct",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "33323",
            "country_code": "US",
            "telephone_number": "954-999-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CROSSROADS WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-999-3458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.