NPIMap

Organization Active NPI

Crossover Health Medical Group

Doing business as Crossover @ Grapevine

  • Multi-Specialty Clinic/Center
  • Grapevine, TX
National Provider Identifier
1689292773
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CROSSOVER HEALTH MEDICAL GROUP
Doing business as
Crossover @ Grapevine
Practice address
1940 Enchanted Way Ste 101
Grapevine, TX 76051-0965
Phone
(949) 891-0328
NPI assigned
Jul 6, 2020
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Angie Sakioka
Title
HR Operations Specialist
Phone
(949) 891-0228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1940 Enchanted Way Ste 101
Grapevine, TX 76051-0965

Mailing address

101 W Avenida Vista Hermosa Ste 120
San Clemente, CA 92672-7707
Phone (949) 891-0328

Other names 1

  • Crossover @ Grapevine 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
45D2194164Crossover Health Medical Group, Apc1940 Enchanted Way Suite 101, Grapevine, TX 76051Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Crossover Medical Group89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

1940 Enchanted Way
Ste 101
Grapevine, TX 76051

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1689292773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W AVENIDA VISTA HERMOSA STE 120",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926727707",
            "telephone_number": "949-891-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ENCHANTED WAY STE 101",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760510965",
            "telephone_number": "949-891-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "SAKIOKA",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "HR OPERATIONS SPECIALIST",
        "authorized_official_telephone_number": "949-891-0228"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossover @ Grapevine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.