| Crossover Health Services Inc | |
|
940 E 36th St N Tulsa OK 74106-1953 | |
| (918) 398-9460 | |
| (918) 398-9460 |
| Full Name | Crossover Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 940 E 36th St N, Tulsa, Oklahoma |
| Authorized Official Name and Position | Sharmien Charnisette Watkins (CFO) |
| Authorized Official Contact | 9183989460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossover Health Services Inc 940 E 36th St N Tulsa OK 74106-1953 Ph: (918) 398-9460 | Crossover Health Services Inc 940 E 36th St N Tulsa OK 74106-1953 Ph: (918) 398-9460 |
| NPI Number | 1407297963 |
|---|---|
| Provider Enumeration Date | 07/12/2013 |
| Last Update Date | 02/02/2024 |
| Medicare PECOS PAC ID | 0345468625 |
|---|---|
| Medicare Enrollment ID | O20140828000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407297963 | NPI | - | NPPES |
| 100089530C | Medicaid | OK | |
| 200514040A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 14202 (Oklahoma) | Primary |
| Provider Name | Nancy L Wespetal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457679573 PECOS PAC ID: 4880616424 Enrollment ID: I20060110000444 |
| Provider Name | Kent G Farish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831176601 PECOS PAC ID: 2668562216 Enrollment ID: I20071219000532 |
| Provider Name | John T Whitaker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205195443 PECOS PAC ID: 8628207040 Enrollment ID: I20140206000436 |
| Provider Name | John Abraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962634535 PECOS PAC ID: 6901027812 Enrollment ID: I20141017001471 |
| Provider Name | Holly E Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972826659 PECOS PAC ID: 4981732963 Enrollment ID: I20150609000168 |
| Provider Name | Sarah Janssen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821418773 PECOS PAC ID: 9931409125 Enrollment ID: I20151119000929 |
| Provider Name | Cynthia (cyndi) A Schneider |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952747768 PECOS PAC ID: 3274890413 Enrollment ID: I20171127001751 |
| Provider Name | Glenna Wong Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013571256 PECOS PAC ID: 3072924414 Enrollment ID: I20201116002567 |
| Provider Name | Crystal L Gazda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982255352 PECOS PAC ID: 7113332594 Enrollment ID: I20210217000733 |
| Provider Name | Natalie K Schaller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265753669 PECOS PAC ID: 8325275282 Enrollment ID: I20230811002384 |
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