Active NPI
Jeremy D. Cross, M.S.P.T.
- Physical Therapist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10958-024
- Practice address
- 725 S Webster Ave
Green Bay, WI 54301-3500 - Phone
- (920) 433-7995
- Fax
- (920) 433-3458
- NPI assigned
- Jan 30, 2007
- Last updated
- Feb 3, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10958-024 | WI | Primary |
Addresses
Primary practice location
725 S Webster Ave
Green Bay, WI 54301-3500
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7822
Other practice location 2
1630 Commanche Ave
Green Bay, WI 54313-6089
Phone (920) 430-4750
Other practice location 3
704 S Webster Ave
Green Bay, WI 54301-3528
Phone (920) 433-3410
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P3663022 | Other | NY | OXFORD HEALTHCARE |
| 027593-1 | Other | NY | LICENSCE NUMBER |
| 36159200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10958-024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Orthopedic & Spine Therapy of New London, SC | Physical Therapist | Past | Accepting new patients |
| Orthopedic & Spine Therapy of New London, SC | Physical Therapist | Past | Accepting new patients |
| John V Murphy Physical Therapy, PC | Past | Accepting new patients | |
| Orthopedic & Spine Therapy of Oshkosh SC | Physical Therapist | Past | Accepting new patients |
Locations
1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700
704 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3784
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
Interoperability endpoints
- jcross32294@direct.thedacare.org
Organizations & group practices 6
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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba FMC Oconto Falls
- Rural Health Clinic/Center
- Oconto Falls, WI
- NPI 1285696963
-
- Physical Therapy Clinic/Center
- Hortonville, WI
- NPI 1164080388
Physical Therapist
-
- Physical Therapy Clinic/Center
- New London, WI
- NPI 1437187135
Physical Therapist
-
- Physical Therapist
- Oshkosh, WI
- NPI 1952418816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1932246246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7210",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013500",
"telephone_number": "920-433-7995",
"fax_number": "920-433-3458"
}
],
"practiceLocations": [
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-7822",
"fax_number": "920-433-3651",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1630 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543136089",
"country_code": "US",
"telephone_number": "920-430-4750",
"fax_number": "920-430-4746",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "704 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013528",
"country_code": "US",
"telephone_number": "920-433-3410",
"fax_number": "920-433-3419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROSS",
"first_name": "JEREMY",
"middle_name": "D.",
"credential": "M.S.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2023-02-03",
"certification_date": "2023-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10958-024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTHCARE",
"identifier": "P3663022",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSCE NUMBER",
"identifier": "027593-1",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36159200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.