CROSSOVER HEALTH MEDICAL GROUP (NPI# 1811273345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811273345 |
| Entity Type | Organization |
| Organization Name | CROSSOVER HEALTH MEDICAL GROUP |
| Practice Address |
2511 Laguna Blvd Ms 217 - Fit Elk Grove CA 95758-7421 |
| Mailing Address |
15 Enterprise #330 Aliso Viejo CA 92656-2652 |
| Practice Telephone | 9498910328 |
| Mailing Telephone | 9498910328 |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2016-10-07 |
| Authorized Official Name | DR. SCOTT LYMAN SHREEVE (OWNER CEO) |
| Authorized Official Telephone | 9498910328 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A74386 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1184231037 | Crossover Health Medical Group | Clinic/Center | 434 Patrol Rd, Jeffersonville, IN 47130-7754 | 2020-09-24 |
| 1982211835 | Crossover Health Medical Group | Clinic/Center | 711 W 2nd St Ste A, San Bernardino, CA 92410-3262 | 2020-09-24 |
| 1619584570 | Crossover Health Medical Group | Clinic/Center | 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 | 2020-09-24 |
| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1992312847 | Crossover Health Medical Group | Clinic/Center | 544 Conestoga Pkwy Ste 3, Shepherdsville, KY 40165-5676 | 2020-09-24 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 W Avenida Vista Hermosa, San Clemente, CA 92672-7706 |
| New York State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 99 Washington Avenue, Suite 1008, Albany, New York 12260 |
| Massachusetts Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 65 Enterprise, Alisa Viejo, CA 92656 |
| Colorado Business Entities | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 West Avenida Vista Hermosa, Suite 120, San Clemente, CA 92672 |
| Street Address |
2511 LAGUNA BLVD MS 217 - FIT |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95758-7421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114412129 | Timaree Hagenburger | Dietitian, Registered | 2511 Laguna Blvd, Elk Grove, CA 95758-7421 | 2018-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982244208 | Obia Njoku | Nurse Practitioner | 9105 Bruceville Rd Ste 1a #580405, Elk Grove, CA 95758 | 2020-01-14 |
| 1992362362 | Kimberly Abrahamson | Student in an Organized Health Care Education/Training Program | 9412 Big Horn Dr #6, Elk Grove, CA 95758 | 2019-05-21 |
| 1447737333 | Elk Grove Rehab & Counseling Center | Counselor | 7807 Laguna Blvd., Suite 480, Elk Grove, CA 95758 | 2018-07-24 |
| 1114424579 | Arielle Mize | Dietitian, Registered | 8161 Sheldon Road, #103, Elk Grove, CA 95758 | 2018-04-11 |
| 1154822609 | Eston Garcia | Behavior Technician | 2366 Martime Drive, Elk Grove, CA 95758 | 2018-02-21 |
| 1912406364 | Nicole Torneros | Behavior Technician | 2336 Maritime Drive, Elk Grove, CA 95758 | 2018-02-12 |
| 1134628712 | Northern California Vasectomy | Family Medicine | 9045 Bruceville Rd Ste 100b, Elk Grove, CA 95758 | 2018-02-08 |
| 1083134399 | Uchechi Mbonu | Assisted Living Facility | 7019 Mcgill Court, Elk Grove, CA 95758 | 2017-06-27 |
| 1922557362 | Muhanad Aliakbar | Driver | 8275 Oakbriar Cir, Elk Grove, CA 95758 | 2016-09-27 |
| 1063868123 | Teresa Vinciguerra | Marriage & Family Therapist | 9412 Elk Horn Blvd, Suite 6, Elk Grove, CA 95758 | 2016-05-09 |
| Find all providers in zip 95758 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477983104 | Jennifer Krawczyk | Specialist | 2612 Duck Call Ct, Elk Grove, CA 95757-8130 | 2013-11-15 |
| 1720175235 | Rachana Neelum Sukhnandan Koura | Specialist | 9727 Elk Grove Florin Rd Ste 250, Elk Grove, CA 95624-2290 | 2006-10-06 |
| 1952497406 | Rahat Saied | Specialist | 9727 Elk Grove Florin Road, #250, Elk Grove, CA 95624 | 2006-10-04 |
| 1851406540 | James T Lin | Specialist | 8021 Laguna Blvd, Suite 3, Elk Grove, CA 95758-7920 | 2006-08-20 |
| 1386118073 | Elizabeth Tolulope Nwani | Specialist | 9258 Marlemont Cir, Elk Grove, CA 95758-7604 | 2019-01-15 |
| 1952850133 | Independent Physicians Office Management, Inc. | Specialist | 9045 Bruceville Rd, Suite 190, Elk Grove, CA 95758-5948 | 2016-09-28 |
| 1356786842 | James T Lin Md Inc | Specialist | 8021 Laguna Blvd, Suite 3, Elk Grove, CA 95758-7920 | 2013-05-09 |
| 1851669030 | Michelle Burke | Specialist | 9280 W Stockton Blvd, Suite 116, Elk Grove, CA 95758-8073 | 2011-12-02 |
| 1437354677 | Elk Grove Pediatrics, Inc | Specialist | 9727 Elk Grove Florin Rd Ste 250, Elk Grove, CA 95624-2290 | 2007-06-18 |
| 1952481848 | Ganga Padmesh | Specialist | 9727 Elk Grove Florin Rd Ste 250, Elk Grove, CA 95624-2290 | 2006-10-16 |
| Find all providers in ELK GROVE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.