Crossroads Clinic Pllc
Crossroads Clinic Pllc is a healthcare organization registered as Primary Care Nurse Practitioner in Ooltewah, TN, holding Type 2 (organization) NPI 1043662687 since 2016. The authorized official on file is Susan Vergot, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1043662687 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Crossroads Clinic Pllc |
| Practice address | 1667 OOLTEWAH RINGGOLD RD, SUITE 111, Ooltewah, TN, 37363 |
| Phone | 4238254881 |
| Fax | 4238254882 |
| Enumeration date | 2016-07-07 |
| Last updated in NPPES | 2016-07-07 |
Authorized official
| Name | Susan Vergot |
|---|---|
| Title | Owner |
| Phone | 4239020681 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363LP2300X | Primary Care Nurse Practitioner | Primary | — | — |
Copy-ready billing details
Provider: Crossroads Clinic Pllc NPI: 1043662687 Taxonomy: 363LP2300X (Primary Care Nurse Practitioner) Address: 1667 OOLTEWAH RINGGOLD RD, SUITE 111, Ooltewah, TN, 37363
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1922256486 | Daniel Platt | Individual | Pharmacist | Ooltewah, TN |
| 1417230129 | Main Street Medical, Pllc | Organization | Specialist | Ooltewah, TN |
| 1295102986 | K-Va-T Food Stores Inc | Organization | Community/Retail Pharmacy | Ooltewah, TN |
| 1760071609 | Michael Booth | Individual | Pharmacist | Ooltewah, TN |
Verify this record
Cross-check NPI 1043662687 against the authoritative CMS record: view Crossroads Clinic Pllc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Crossroads Clinic Pllc?
What is the NPI number for Crossroads Clinic Pllc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2016-07-07.