| Crossroads Treatment Centers Of Tennessee, Pc | |
|
2305 N Gateway Ave Unit 4 Harriman TN 37748-8683 | |
| (800) 805-6989 | |
| Not Available |
| Full Name | Crossroads Treatment Centers Of Tennessee, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2305 N Gateway Ave Unit 4, Harriman, Tennessee |
| Authorized Official Name and Position | Credentialing Staff (PRESIDENT/CEO) |
| Authorized Official Contact | 8008056989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Treatment Centers Of Tennessee, Pc 55 Beattie Pl Ste 810 Greenville SC 29601-2191 Ph: (800) 805-6989 | Crossroads Treatment Centers Of Tennessee, Pc 2305 N Gateway Ave Unit 4 Harriman TN 37748-8683 Ph: (800) 805-6989 |
| NPI Number | 1316403405 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 07/01/2021 |
| Medicare PECOS PAC ID | 6204262025 |
|---|---|
| Medicare Enrollment ID | O20200213002831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316403405 | NPI | - | NPPES |
| Provider Name | Verna Bain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396816997 PECOS PAC ID: 5799754057 Enrollment ID: I20041002000090 |
| Provider Name | Eleanor J Farber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043459092 PECOS PAC ID: 6709936230 Enrollment ID: I20090604000148 |
| Provider Name | Tracy L Stratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043532419 PECOS PAC ID: 5496882300 Enrollment ID: I20100426000285 |
| Provider Name | Mack Hicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154354900 PECOS PAC ID: 3678656790 Enrollment ID: I20101018000913 |
| Provider Name | Paul I Pyles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568496560 PECOS PAC ID: 4880799410 Enrollment ID: I20101104001220 |
| Provider Name | John M Rodney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891944708 PECOS PAC ID: 4789711300 Enrollment ID: I20110216000233 |
| Provider Name | Desiree Roa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477714442 PECOS PAC ID: 5496924045 Enrollment ID: I20110816000571 |
| Provider Name | Joanna G Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013353176 PECOS PAC ID: 1658514500 Enrollment ID: I20130826000560 |
| Provider Name | Everald Uriah Walker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922444363 PECOS PAC ID: 5991933327 Enrollment ID: I20160907001237 |
| Provider Name | Ladonna Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780044792 PECOS PAC ID: 6507145067 Enrollment ID: I20161128001881 |
| Provider Name | Jonathan Manuel Rey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679745368 PECOS PAC ID: 1254529613 Enrollment ID: I20170220001411 |
| Provider Name | Jacob P Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114449881 PECOS PAC ID: 6901172766 Enrollment ID: I20171023000708 |
| Provider Name | Julia V Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336615871 PECOS PAC ID: 8628304888 Enrollment ID: I20190725000744 |
| Provider Name | Michael Minh Dao |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1013983709 PECOS PAC ID: 7618204561 Enrollment ID: I20190814004156 |
| Provider Name | Michael D Talbot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467588137 PECOS PAC ID: 9436573201 Enrollment ID: I20200727002027 |
| Provider Name | Ginger Ketron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295260537 PECOS PAC ID: 0648681569 Enrollment ID: I20201125002554 |
| Provider Name | Janet C Pelmore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871615344 PECOS PAC ID: 6103239967 Enrollment ID: I20210115001431 |
| Provider Name | Ray Anthony Mercado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275606030 PECOS PAC ID: 6305960337 Enrollment ID: I20210129001723 |
| Provider Name | Brittonya Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528626496 PECOS PAC ID: 2961821582 Enrollment ID: I20210210000888 |
| Provider Name | Kevin Mewborn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669435327 PECOS PAC ID: 6103895164 Enrollment ID: I20210520002696 |
| Provider Name | Samir Rizk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194759449 PECOS PAC ID: 3274771118 Enrollment ID: I20210603001697 |
| Provider Name | Evelyn Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245670041 PECOS PAC ID: 1052797297 Enrollment ID: I20220926002686 |
| Provider Name | James T Brockman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417921057 PECOS PAC ID: 7719908094 Enrollment ID: I20220929002099 |
| Provider Name | Margarite Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447616891 PECOS PAC ID: 8820465040 Enrollment ID: I20221101001366 |
| Provider Name | Jessica Matthews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134623192 PECOS PAC ID: 8628454774 Enrollment ID: I20221117002535 |
| Provider Name | Arisha Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669198248 PECOS PAC ID: 5193196715 Enrollment ID: I20230118002532 |
| Provider Name | Hope Kicklighter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538860622 PECOS PAC ID: 1951765775 Enrollment ID: I20230913000515 |
Mancel Wakham, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2497 S Roane St Ste 110, Harriman, TN 37748 Phone: 865-647-3575 | |
Clary Foote Md P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2319 S Roane St, Harriman, TN 37748 Phone: 865-882-2800 Fax: 865-882-3512 | |
Steven A Crews, Do, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2305 N Gateway Ave Unit 2, Harriman, TN 37748 Phone: 865-348-5854 | |
Roane Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Devonia St, Harriman, TN 37748 Phone: 865-882-4440 | |
Clary Foote Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2319 S Roane St, Harriman, TN 37748 Phone: 865-882-2800 Fax: 865-882-3512 | |
Roane Health Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 S Roane Street, Harriman, TN 37748 Phone: 965-740-2497 |