Individual provider Active NPI

Spicelyn A Cross

  • Acute Care Nurse Practitioner
  • Shenandoah, TX
National Provider Identifier
1811508963
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP144083 Issued in TX
Practice address
9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone
(713) 897-2300
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP144083 TX Primary

Addresses

Primary practice location

9250 Pinecroft Dr
Shenandoah, TX 77380-3218

Mailing address

9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone (713) 897-2300

Other practice location 1

9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone (713) 897-2300

Other practice location 2

703 S Fleishel Ave
Tyler, TX 75701-2015
Phone (903) 606-6139

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spicelyn.cross@memorialhermann.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725004815 TX Practitioner - Nurse Practitioner 8527504505 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP144083TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Sep 9, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 13, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 9, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Tyler, TX 75701
Phone (903) 606-3000

Interoperability endpoints

  • Direct secure messaging: scross395427@christushealth.direct-ci.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1811508963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 PINECROFT DR",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803218",
            "telephone_number": "713-897-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 PINECROFT DR",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803218",
            "telephone_number": "713-897-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9250 Pinecroft Dr",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773803218",
            "country_code": "US",
            "telephone_number": "713-897-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 S Fleishel Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-606-6139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSS",
        "first_name": "SPICELYN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP144083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spicelyn.cross@memorialhermann.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9250 Pinecroft Dr",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773803218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.