NPIMap

Organization Active NPI

Crossover Health Medical Group

  • Specialist
  • Elk Grove, CA
National Provider Identifier
1811273345
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A74386 Issued in CA
Legal business name
CROSSOVER HEALTH MEDICAL GROUP
Practice address
2511 Laguna Blvd
Ms 217 - Fit
Elk Grove, CA 95758-7421
Phone
(949) 891-0328
NPI assigned
Oct 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Dr. Scott Lyman Shreeve, M.D.
Title
Owner Ceo
Phone
(949) 891-0328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A74386 CA Primary

Addresses

Primary practice location

2511 Laguna Blvd
Ms 217 - Fit
Elk Grove, CA 95758-7421

Mailing address

15 Enterprise
#330
Aliso Viejo, CA 92656-2652
Phone (949) 891-0328

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
05D2033270Crossover Health Medical Group, Apc2511 Laguna Blvd, Elk Grove, CA 95758Certificate of waiverNov 12, 2027

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 19

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

View all 19

Locations

2511 Laguna Blvd
#217
Elk Grove, CA 95758
Phone (916) 399-5261

NPI Registry JSON

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1811273345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE",
            "address_2": "#330",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562652",
            "telephone_number": "949-891-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 LAGUNA BLVD",
            "address_2": "MS 217 - FIT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587421",
            "telephone_number": "949-891-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "SHREEVE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "LYMAN",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "949-891-0328",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A74386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.