NPIMap

Organization Active NPI

Crossroads Medical Group, P.a.

  • Internal Medicine Physician
  • Balitmore, MD
National Provider Identifier
1720041890
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CROSSROADS MEDICAL GROUP, P.A.
Practice address
2700 Quarry Lake Drive
Suite 350
Balitmore, MD 21209-0000
Phone
(410) 998-9955
Fax
(410) 998-9961
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Authorized official

Name
Dr. Samuel I Benesh, M.D.
Title
President
Phone
(410) 998-9955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD Primary

Addresses

Primary practice location

2700 Quarry Lake Drive
Suite 350
Balitmore, MD 21209-0000

Mailing address

2700 Quarry Lake Drive
Suite 350
Baltimore, MD 21209-0000
Phone (410) 998-9955

National Provider Directory

National Provider Directory

Locations

900 Conference Dr
Ste 16
Goodlettsville, TN 37072

125 Indian Lake Blvd
Hendersonville, TN 37075
Phone (615) 909-3552

1047 Glenbrook Way
Ste 120
Hendersonvlle, TN 37075
Phone (615) 590-2020

5045 Old Hickory Blvd
Ste 100
Hermitage, TN 37076
Phone (615) 884-7674

Practitioners & affiliated clinicians

Practitioners 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1720041890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DRIVE",
            "address_2": "SUITE 350",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212090000",
            "telephone_number": "410-998-9955",
            "fax_number": "410-998-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DRIVE",
            "address_2": "SUITE 350",
            "city": "BALITMORE",
            "state": "MD",
            "postal_code": "212090000",
            "telephone_number": "410-998-9955",
            "fax_number": "410-998-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "BENESH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-998-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Balitmore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.