NPIMap

Organization Active NPI

Crossroads Treatment Center of Greensboro, PC

Doing business as Crossroads Treatment Center of Greensboro (Lab)

  • Clinical Medical Laboratory
  • Greensboro, NC
National Provider Identifier
1639744063
Registry record updated Jun 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CROSSROADS TREATMENT CENTER OF GREENSBORO, PC
Doing business as
Crossroads Treatment Center of Greensboro (Lab)
Practice address
2706 N Church St
Greensboro, NC 27405-3657
Phone
(800) 805-6989
Fax
(864) 558-8511
NPI assigned
May 27, 2021
Last updated
Jun 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CROSSROADS TREATMENT CENTER OF GREENSBORO, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2022

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

Authorized official

Name
Rupert James McCormacNPI 1669486239
Title
President
Phone
(800) 805-6989

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2706 N Church St
Greensboro, NC 27405-3657

Mailing address

200 E Broad St Ste 300
Greenville, SC 29601-2891
Phone (800) 805-6989

Other identifiers 1

IdentifierTypeStateIssuer
34D2083457OtherNCCLIA

Other names 1

  • Crossroads Treatment Center of Greensboro (Lab) Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2083457Crossroads Treatment Center of Greensboro, PC2706 North Church Street, Greensboro, NC 27405Certificate of waiverNov 30, 2027

National Provider Directory

National Provider Directory
Part of
Crossroads Treatment Center

Locations

2706 N Church St
Greensboro, NC 27405
Phone (336) 272-9990

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655510400000",
    "number": "1639744063",
    "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",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053657",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS TREATMENT CENTER OF GREENSBORO, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROSSROADS TREATMENT CENTER OF GREENSBORO, PC",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-06-18",
        "certification_date": "2021-11-29",
        "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": "800-805-6989"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D2083457",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Treatment Center of Greensboro (Lab)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Treatment Center of Greensboro (Lab)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.