NPIMap

Organization Active NPI

Cross Creek Redi Care

  • Emergency Medicine Physician
  • Hamilton, MS
National Provider Identifier
1881818219
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CROSS CREEK REDI CARE
Practice address
40023 Cross Creek
Hamilton, MS 39746
Phone
(662) 343-5093
NPI assigned
Apr 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Chris Dedeaux
Title
Clinic Administrator
Phone
(662) 256-7112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

40023 Cross Creek
Hamilton, MS 39746

Mailing address

123 Main St N
Amory, MS 38821-3416

National Provider Directory

National Provider Directory
Tax ID family
Nettleton Family Clinic17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

900 Earl Frye Blvd
Ste C
Amory, MS 38821
Phone (662) 256-6227

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881818219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MAIN ST N",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388213416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40023 CROSS CREEK",
            "city": "HAMILTON",
            "state": "MS",
            "postal_code": "39746",
            "telephone_number": "662-343-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CREEK REDI CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEDEAUX",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "662-256-7112"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.