Cross Road Health Ministries, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Glennallen, AK

NPI 1609871391 · NPPES record last updated Mar 31, 2026

Key facts

NPI
1609871391
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
10300 (AK)
Legal business name
CROSS ROAD HEALTH MINISTRIES, INC.
Practice address
Mile 187 Glenn Highway
Glennallen, AK 99588-0589
Phone
(907) 822-3203
Fax
(907) 822-5805
NPI assigned
Jun 17, 2005
Organization subpart
No

Authorized official

Name
Steven William Gallagher
Title
Ceo
Phone
(907) 822-5686

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AK

Federally qualified health center certification: CCN 021820

Legal name
CROSS ROAD HEALTH MINISTRIES INC
Doing business as
CROSS ROAD MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 14, 2004
Last certification
Jan 14, 2004
Ownership / control type
For profit – individual
Organization structure
Corporation · Non-profit
Incorporated
May 16, 1988 in AK
Enrollment address
Mile 187 Glenn Highway
Glennallen, AK 99588-0589

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cathy T Knighten
Individual
Corporate Officer Apr 28, 2016
Gayle Kildal
Individual
Corporate Director Apr 28, 2016
Joel R Medendorp
Individual
Corporate Director Sep 22, 2010
W-2 Managing Employee Sep 22, 2010
Mary Howarth-Hernandez
Individual
Corporate Officer Apr 28, 2016
Sharon Daniel
Individual
Corporate Officer Apr 28, 2016
Daniel Case
Individual
Corporate Officer
Cfo
Dec 5, 2022
Corporate Director Dec 5, 2022
W-2 Managing Employee
Cfocfo
Dec 5, 2022
Operational/Managerial Control
Cfo
Dec 5, 2022
Carol Neeley
Individual
Corporate Officer Apr 28, 2016
Dawn Grossmann
Individual
Corporate Director Apr 28, 2016
Michael D Roscovius
Individual
Corporate Director
(Vice Chair) Vice President
Dec 13, 2003
Rose Tyone
Individual
Corporate Officer Apr 28, 2016
Jason Severs
Individual
Corporate Director Apr 28, 2016
Karl Bengston
Individual
Corporate Director Sep 22, 2010
Susan E Sutherland
Individual
Corporate Officer
Grants Manager
Mar 31, 2015
W-2 Managing Employee Sep 22, 2010

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031108000028 AK Part a Provider - Federally Qualified Health Center (FQHC) 4688587348 Practice locations: Glennallen, AK
O20040401001184 AK Part B Supplier - Clinic/Group Practice 4688587348 Receives reassigned benefits from 23 practitioners
2 other NPIs on this enrollment
Practice locations: Delta Junction, AK; Glennallen, AK; Tok, AK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 10300 AK Yes
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

Mile 187 Glenn Highway
Glennallen, AK 99588-0589

Mailing address

PO Box 5
Glennallen, AK 99588-0589
Phone (907) 822-5686

Other identifiers

IdentifierTypeStateIssuer
1029903MedicaidAK

Other names

  • Cross Road Medical Center Doing business as

Other providers in Glennallen, AK

All providers in Glennallen, AK · Federally Qualified Health Center (FQHC) in Alaska

Sources for this page

Verify at the official NPI Registry.