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CROSS TRAILS MEDICAL CENTER
NPI 1033895628
Clinic/Center - Federally Qualified Health Center (FQHC) in Cape Girardeau, MO

Active since June 27, 2023CLIA Certified · 2 labs
2430 GOLDEN STREET, CAPE GIRARDEAU, MO 63703(573) 339-1196(573) 339-9378 Get Directions Write a Review

NPPES record last updated: June 27, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Cross Trails Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CROSS TRAILS MEDICAL CENTER (NPI 1033895628) is a healthcare organization registered as a federally qualified health center (fqhc) in Cape Girardeau, Missouri and active in the NPI registry since June 2023. The organization holds 2 active CLIA laboratory certificates and lists Sheila Pruitt, Billing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1033895628
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCROSS TRAILS MEDICAL CENTER
Location Address2430 GOLDEN STREETCape Girardeau, MO 63703
Mailing Address408 S Broadview StCape Girardeau, MO 63703-5725 · (573) 332-0808 · Fax (573) 339-7945
Phone(573) 339-1196
Fax(573) 339-9378
Organization SubpartYes
Authorized OfficialSheila PruittBilling Coordinator · (573) 332-0808
Enumeration DateJune 27, 2023
NPPES CertifiedJune 13, 2023
✔ NPI 1033895628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
2430 GOLDEN STREET, Cape Girardeau, MO 63703
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cross Trails Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

22

Medicare enrollment records show 22 clinicians reassign Medicare billing to Cross Trails Medical Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 16 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Dentist8
Nurse Practitioner6
Family Practice2
Internal Medicine2
Clinical Social Worker1
Infectious Disease1
Oral Surgery1
Pediatric Medicine1

Nearest to this location (20)

See all 22
Constance Koerner Miller, LCSW
Clinical Social Worker
NPI 1386108181
2430 GOLDEN ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOS✔ Accepts MedicareSame address
Carly Cameron, DMD
Dentist
NPI 1043145451
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOSSame address
Janna Crosnoe, M.D.
Family Practice
NPI 1720017296
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOS✔ Accepts MedicareSame address
Sarah Goodman, D.O.
Internal Medicine
NPI 1962645838
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOS✔ Accepts MedicareSame address
Julia Lincicum
Dentist
NPI 1356070890
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOSSame address
Jessica Ludwig, FNP-BC
Nurse Practitioner
NPI 1407125370
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOS✔ Accepts MedicareSame address
Ann Martin, DDS
Dentist
NPI 1740170083
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOSSame address
Mckenzie Shirley
Dentist
NPI 1235828278
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 334-4753
✔ PECOSSame address
Karen Tracy, F.N.P.
Nurse Practitioner
NPI 1346252293
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 332-0808
✔ PECOS✔ Accepts MedicareSame address
Jasmin Tucker, DDS
Dentist
NPI 1356037626
408 S BROADVIEW ST
Cape Girardeau, MO 63703
(573) 339-1196
✔ PECOSSame address
Brenna Maria Keller, D.O.
Infectious Disease
NPI 1932261104
211 SAINT FRANCIS DR SPECIALTY CLINIC
Cape Girardeau, MO 63703
(573) 331-5932
✔ PECOS0.9 mi
Munira Rahman-Anwar, DO
Pediatric Medicine
NPI 1639597578
25 DOCTORS PARK
Cape Girardeau, MO 63703
(573) 331-6750
✔ PECOS1.1 mi
Amanda Pleimann-King, D.O.
Family Practice
NPI 1659722155
817 S MOUNT AUBURN RD
Cape Girardeau, MO 63703
(573) 519-4500
✔ PECOS✔ Accepts Medicare1.4 mi
157 SIEMERS DR # 106
Cape Girardeau, MO 63701
(573) 970-3275
✔ PECOS1.5 mi
Dana Moore, APRN
Nurse Practitioner
NPI 1760730139
1349 N MOUNT AUBURN RD
Cape Girardeau, MO 63701
(573) 334-9564
✔ PECOS✔ Accepts Medicare2.1 mi
Amy Massa, RN, FNP-BC
Nurse Practitioner
NPI 1760739668
545 BROADRIDGE DR
Jackson, MO 63755
(573) 243-8408
✔ PECOS✔ Accepts Medicare9.6 mi
Curtis Jansen, D.O.
Internal Medicine
NPI 1447530597
109 STATE HIGHWAY 51 N
Marble Hill, MO 63764
(573) 238-2725
✔ PECOS✔ Accepts Medicare23 mi
Suzana Gjino
Dentist
NPI 1396300547
307 W GABRIEL ST
Advance, MO 63730
(573) 722-3034
✔ PECOS24 mi
Sherri Mcdonald, APRN,BC,FNP
Nurse Practitioner
NPI 1639267990
400 S MAIN ST
Charleston, MO 63834
(573) 683-3739
✔ PECOS28 mi
Angela Spoljaric, DMD
Oral Surgery
NPI 1235114489
401 HOLLY HILLS AVE
Saint Louis, MO 63111
(314) 353-5190
✔ PECOS95 mi
See all 22 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 26D0931072

Cross Trails Medical Center · Cape Girardeau, MO
Active · expires Dec 14, 2027
CLIA Number26D0931072
Laboratory TypePhysician Office
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorCurtis L. Jansen
Laboratory Phone(573) 332-0808
Laboratory LocationCross Trails Medical Center408 South Broadview Street, Cape Girardeau, MO 63703
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 26D2082659

Cross Trails Medical Center · Cape Girardeau, MO
Active · expires Dec 2, 2026
CLIA Number26D2082659
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2024
Certificate Expiration DateDecember 2, 2026
Laboratory DirectorCurtis L. Jansen
Laboratory Phone(573) 339-1196
Laboratory LocationCross Trails Medical Center2430 Golden Street, Cape Girardeau, MO 63703
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cross Trails Medical Center's NPI number?

The NPI number for Cross Trails Medical Center is 1033895628. It was assigned to this organization in the NPPES registry on June 27, 2023.

Where is Cross Trails Medical Center located?

Cross Trails Medical Center is located at 2430 Golden Street, Cape Girardeau, MO 63703. The listed phone number is (573) 339-1196.

What is Cross Trails Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Cross Trails Medical Center enrolled in Medicare?

Yes. Cross Trails Medical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Cross Trails Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 8 Medicare specialties reassign their Medicare billing to Cross Trails Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dentist (8), Nurse Practitioner (6) and Family Practice (2). Of these, 1 practice at this address and 16 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Cross Trails Medical Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Cross Trails Medical Center accept?

Health plans from Anthem Blue Cross and Blue Shield list Cross Trails Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Cross Trails Medical Center was last updated on June 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.