NPIMap

Organization Active NPI

Crossroads Hospice of Northeast Ohio, LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Uniontown, OH
National Provider Identifier
1831806173
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
CROSSROADS HOSPICE OF NORTHEAST OHIO, LLC
Practice address
3743 Boettler Oaks Dr Ste E
Uniontown, OH 44685-6227
Phone
(330) 899-9100
Fax
(330) 899-9972
NPI assigned
Nov 4, 2022
Organization subpart
Yes
Parent organization
CARREFOUR ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Clayton Lee Farmer
Title
Cfo/Coo
Phone
(918) 627-6846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

3743 Boettler Oaks Dr Ste E
Uniontown, OH 44685-6227

Mailing address

10810 E 45TH St Ste 300
Tulsa, OK 74146-3816
Phone (918) 627-6846

Other names 2

  • Crossroads Hospice of Northeast Ohio, LLC Doing business as
  • Crossroads Hospice & Palliative Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Hospice and Palliative Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3743 Boettler Oaks Dr
Ste E
Green, OH 44685
Phone (330) 899-9100

Practitioners & affiliated clinicians

Practitioners 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1831806173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 E 45TH ST STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463816",
            "telephone_number": "918-627-6846",
            "fax_number": "918-627-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3743 BOETTLER OAKS DR STE E",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446856227",
            "telephone_number": "330-899-9100",
            "fax_number": "330-899-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS HOSPICE OF NORTHEAST OHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARREFOUR ASSOCIATES, LLC",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "918-627-6846"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Hospice of Northeast Ohio, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Hospice & Palliative Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Uniontown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.