Crossroads Isl, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CROSSROADS ISL, LLC

Practice address

240 N Kingshighway St
Sikeston, MO 63801-4102

Phone

(573) 472-9696

Fax

(573) 472-9494

NPI assigned

Jan 25, 2007

Last updated

Sep 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edward Miller

Title

Director

Phone

(573) 472-9696

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Crossroads Isl LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Crossroads Isl, LLC

  • Developmentally Disabled Services Day Training Agency
  • Sikeston, MO
  • NPI 1427102482
  NPD tax ID
• Crossroads Isl, LLC

  • Developmentally Disabled Services Day Training Agency
  • Sikeston, MO
  • NPI 1730234931
  NPD tax ID

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1821143025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014102",
            "telephone_number": "573-472-9696",
            "fax_number": "573-472-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014102",
            "telephone_number": "573-472-9696",
            "fax_number": "573-472-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS ISL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-472-9696",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286107305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristopher R. Crawford, M.D.
• Christopher Creecy, PLPC
• Michael Edward Critchlow, M. D.
• Crossroads Isl, LLC
• Crossroads Isl, LLC
• Sarah H Curry, MD
• David Dahlbeck, PHD
• Ryan Jon Dalisky, DO
• Brandy Melisa Dallas, PT
• Tracy Davied, PT

• Home Health Agency in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.