Individual provider Active NPI

Jeremy D. Cross, M.S.P.T.

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1932246246
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10958-024 Issued in WI
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, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
P3663022OtherNYOXFORD HEALTHCARE
027593-1OtherNYLICENSCE NUMBER
36159200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000612 WI Practitioner - Physical Therapist in Private Practice 8921065582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10958-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Dec 20, 2019 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 PastSince May 18, 2025 Accepting new patients
John V Murphy Physical Therapy, PC PastSince Mar 7, 2005 Accepting new patients
Orthopedic & Spine Therapy of Oshkosh SC Physical Therapist PastSince Jun 15, 2025 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.