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CROSSROADS FAMILY MEDICINE OF MT VERNON
NPI 1669466686
Clinic/Center - Rural Health in Mount Vernon, IL

Active since September 06, 2005
3505 BROADWAY ST, MOUNT VERNON, IL 62864(618) 241-8772(618) 241-8775 Get Directions Write a Review

NPPES record last updated: August 10, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Crossroads Family Medicine Of Mt Vernon NPPES

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

CROSSROADS FAMILY MEDICINE OF MT VERNON (NPI 1669466686) is a healthcare organization registered as a rural health in Mount Vernon, Illinois and active in the NPI registry since September 2005. The organization lists Debbie Brewer, Director Of Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1669466686
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCROSSROADS PHYSICIAN CORP
Location Address3505 BROADWAY STMount Vernon, IL 62864-2202
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7626
Phone(618) 241-8772
Fax(618) 241-8775
Organization SubpartYes
Authorized OfficialDebbie BrewerDirector Of Provider Enrollment · (615) 465-7626
Enumeration DateSeptember 6, 2005
Last NPPES UpdateAugust 10, 2011
✔ NPI 1669466686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
3505 BROADWAY ST, Mount Vernon, IL 62864
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Other Names 1

Doing Business AsCrossroads Family Medicine Of Mt Vernon

Other Identifiers 2

Medicaid036041176IL
Medicare OSCAR/certification148983IL

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDERSON FAMILY PRACTICE
Clinic/Center (Primary Care)
3505 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 244-7788
JOHN HALL, M.D., P.C.
Family Medicine (Adult Medicine)
3505 BROADWAY ST, STE A
MOUNT VERNON, IL 62864
Jefferson County (618) 244-7788
MT. VERNON CHIROPRACTIC CLINIC, PLLC
Chiropractor
3505 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4554

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 Crossroads Physician Corp's NPI number?

The NPI number for Crossroads Physician Corp is 1669466686. It was assigned to this organization in the NPPES registry on September 6, 2005. The provider is doing business as Crossroads Family Medicine Of Mt Vernon.

Where is Crossroads Physician Corp located?

Crossroads Physician Corp is located at 3505 Broadway St, Mount Vernon, IL 62864. The listed phone number is (618) 241-8772.

What is Crossroads Physician Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Crossroads Physician Corp was last updated on August 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.