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
Last updated
Jan 7, 2011By the provider in NPPES
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 Physician 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

4801 Dorsey Hall Dr
Ste 130
Ellicott City, MD 21042
Phone (410) 730-9851

900 Conference Dr
Ste 16
Goodlettsville, TN 37072

3500 N Mount Juliet Rd
Ste 203
Mount Juliet, TN 37122
Phone (615) 444-0465

2528 Highway 49 E
Ste A
Pleasant View, TN 37146
Phone (615) 746-1615

491 Sage Rd N
Ste 200
White House, TN 37188
Phone (615) 272-7122

Practitioners & affiliated clinicians

Practitioners 40

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.

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": "",
            "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.