Organization Active NPI

Crossroads Medical Associates, LLC

  • Internal Medicine Physician
  • Ellicott City, MD
National Provider Identifier
1720103500
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CROSSROADS MEDICAL ASSOCIATES, LLC
Practice address
4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone
(410) 997-7660
Fax
(410) 997-5377
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Dr. Warren Marc Ross, M.D.
Title
Founding Partner
Phone
(410) 997-7660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766

Mailing address

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone (410) 997-7660

National Provider Directory

National Provider Directory

Locations

4801 Dorsey Hall Dr
#S201
Ellicott City, MD 21042
Phone (410) 997-7660

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1720103500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-7660",
            "fax_number": "410-997-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-7660",
            "fax_number": "410-997-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "FOUNDING PARTNER",
        "authorized_official_telephone_number": "410-997-7660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.