Cross Road Health Ministries, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Tok, AK
NPI 1659956449 · NPPES record last updated Apr 29, 2025
Key facts
- NPI
- 1659956449
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CROSS ROAD HEALTH MINISTRIES, INC.
- Practice address
- Mile Post 1314.5 Alaska Hwy.
Tok, AK 99780 - Phone
- (907) 822-3203
- NPI assigned
- Mar 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Steve Gallagher
- Title
- Ceo
- Phone
- (907) 822-3203
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Practitioners 23
-
Andrew Peter Cap, MD, PHD
-
Amber Michele Lorenzana, FNP-BC
-
Peggy L O'Connor, FNP
-
Thomas Michael Peek, MS NCC
-
Kent Steele, PA-C
-
Amanda Renee Tortorige, LPC; LCPC
-
Verna Jean Schad, CNP
-
Ruth Hunt, MSN, APRN, FNP-BC
-
Carl Lester Brown Jr., PA-C
-
Gail Ann Combs, PA-C
-
Diane L Duntze, ANP
-
Christine Frost, PA-C
-
Marcel Page Herring, PA-C
-
Donald G Hudson, DO
-
Sean Richardson, D.O.
-
Rachael Brock, PA
-
Jonathan Paul Clemens, DMSC, PA-C
-
Charlotte Gaye Ellis, APRN-BC
-
James Morgan Freuler, PA-C
-
Catherine Henderson, FNP
-
Andrew G. Neal, RN, MS(N), FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK
Federally qualified health center certification: CCN 021002
- Legal name
- CROSS ROAD HEALTH MINISTRIES INC
- Doing business as
- TOK MEDICAL CLINIC TMC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 19, 2024
- Last certification
- Apr 19, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1314.5 Alaska Highway
Tok, AK 99780
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Steven Gallagher |
Corporate Officer |
Feb 1, 2024 | 100% |
| Corporate Director |
Feb 1, 2024 | 100% | |
| W-2 Managing Employee | Feb 1, 2024 | 100% | |
| Lloyd Wilhelm |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Sharon Daniel |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Daniel Case |
Corporate Director |
Feb 1, 2024 | 100% |
| Carol Neeley |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Cheryl Helkenn |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Dawn Grossmann |
Corporate Officer | Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Thomas Carnahan |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Rose Tyone |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Richard Dennis |
Corporate Officer | Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Dean Jazzo |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% | |
| Jason Severs |
Corporate Officer |
Feb 1, 2024 | 10% |
| Corporate Director |
Feb 1, 2024 | 10% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040401001184 | AK | Part B Supplier - Clinic/Group Practice | 4688587348 |
Receives reassigned benefits from 23 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Delta Junction, AK; Glennallen, AK; Tok, AK |
| O20240320001763 | AK | Part a Provider - Federally Qualified Health Center (FQHC) | 4688587348 | Practice locations: Tok, AK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
Mile Post 1314.5 Alaska Hwy.
Tok, AK 99780
Mailing address
PO Box 5
Glennallen, AK 99588-0589
Phone (907) 822-3203
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1748425 | Medicaid | AK |
Other names
- Tok Medical Clinic
Other providers in Tok, AK
- Arron Atchley
- Charlene A Cleary
- Joetta Lynn Thompson Colquette
- Richard Thomas Combs
- Susan Young Crawford
- Susan Catherine Hanson
- Sheila Kathleen Hay
- Jacqueline Howard
- Molly Hutsinpiller
- Jordyn James
All providers in Tok, AK · Federally Qualified Health Center (FQHC) in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.