NPIMap

Organization Active NPI

Crossroads Treatment Centers of Tennessee, P.C.

Doing business as CRossroads Treatment Centers Shelby Oak

  • Clinic/Center
  • Memphis, TN
National Provider Identifier
1629733779
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.
Doing business as
CRossroads Treatment Centers Shelby Oak
Practice address
5901 Shelby Oaks Dr
Memphis, TN 38134-7312
Phone
(800) 805-6989
NPI assigned
Nov 3, 2021
Last updated
Nov 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Rupert James McCormac, MDNPI 1669486239
Title
President
Phone
(864) 527-3145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinic/Center 261Q00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Methadone Clinic 261QM2800X

Addresses

Primary practice location

5901 Shelby Oaks Dr
Memphis, TN 38134-7312

Mailing address

200 E Broad St Ste 300
Greenville, SC 29601-2891

Other names 1

  • CRossroads Treatment Centers Shelby Oak Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200213002831 TN Part B Supplier - Clinic/Group Practice 6204262025 Receives reassigned benefits from 45 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tullahoma, TN; Sparta, TN; Oak Ridge, TN; Newport, TN; Morristown, TN; Johnson City, TN; Knoxville, TN; Jacksboro, TN…

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

5901 Shelby Oaks Dr
Memphis, TN 38134

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1629733779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E BROAD ST STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 SHELBY OAKS DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347312",
            "telephone_number": "800-805-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTERS OF TENNESSEE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "MCCORMAC",
        "authorized_official_first_name": "RUPERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-527-3145",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRossroads Treatment Centers Shelby Oak",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.