NPIMap

Organization Active NPI

National Healthcare of Mt Vernon Inc

Doing business as Crossroads Family Medicine of Mt Vernon

  • Rural Health Clinic/Center
  • Mount Vernon, IL
National Provider Identifier
1962753277
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0003947 Issued in IL
Legal business name
NATIONAL HEALTHCARE OF MT VERNON INC
Doing business as
Crossroads Family Medicine of Mt Vernon
Practice address
209 Crossroads PL
Suite 120
Mount Vernon, IL 62864-6545
Phone
(618) 244-6222
Fax
(618) 244-7299
NPI assigned
Sep 26, 2012
Last updated
Apr 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Authorized official

Name
Tara P Richardson
Title
Authorized Offical
Phone
(615) 221-3672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0003947 IL Primary

Addresses

Primary practice location

209 Crossroads PL
Suite 120
Mount Vernon, IL 62864-6545

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (800) 709-7338

Other names 1

  • Crossroads Family Medicine of Mt Vernon Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1962753277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "800-709-7338",
            "fax_number": "615-469-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL",
            "address_2": "SUITE 120",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646545",
            "telephone_number": "618-244-6222",
            "fax_number": "618-244-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL HEALTHCARE OF MT VERNON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "615-221-3672"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IL",
            "license": "0003947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Family Medicine of Mt Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.