Organization Active NPI

Crossroads Pediatric Acute Care LLC

  • Pediatrics Physician
  • Columbus, GA
National Provider Identifier
1780164608
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CROSSROADS PEDIATRIC ACUTE CARE LLC
Practice address
7901 Veterans Pkwy
Columbus, GA 31909-1723
Phone
(706) 507-4995
Fax
(706) 507-4998
NPI assigned
Aug 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Authorized official

Name
Dana Cason, MDNPI 1982696092
Title
Ceo
Phone
(706) 507-4995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7901 Veterans Pkwy
Columbus, GA 31909-1723

Mailing address

7901 Veterans Pkwy
Columbus, GA 31909-1723
Phone (706) 507-4995

Other identifiers 1

IdentifierTypeStateIssuer
039302OtherGALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190422001037 GA Part B Supplier - Clinic/Group Practice 9133461288 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, GA

National Provider Directory

National Provider Directory

Locations

5120 Warm Springs Rd
Ste I
Columbus, GA 31909

Practitioners & affiliated clinicians

Practitioners 1

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": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1780164608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091723",
            "telephone_number": "706-507-4995",
            "fax_number": "706-507-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091723",
            "telephone_number": "706-507-4995",
            "fax_number": "706-507-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS PEDIATRIC ACUTE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "CASON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-507-4995",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "039302",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.