MEDICARE: CROSSROADS URGENT CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261QP2300X	Primary Care Clinic/Center
3	261QU0200X	Urgent Care Clinic/Center
4	363A00000X	Physician Assistant
5	363L00000X	Nurse Practitioner
6	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1316672751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSROADS URGENT CARE PLLC

Provider Business Mailing Address
First Line	:	30 BURTON HILLS BLVD STE 175
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6403
Country	:	US
Telephone Number	:	615-864-8709
Fax Number	:	615-301-6558

Provider Business Practice Location Address
First Line	:	2006 MEMORIAL BLVD STE 101
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3905
Country	:	US
Telephone Number	:	615-380-8411
Fax Number	:	615-380-8420

Authorized Official
Title or Position	:	CONTROLLER
Name	:	STEPHANIE HICKS
Credential	:
Telephone Number	:	615-988-2004

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	03/26/2025

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