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Crossroads Medical Management LLC

Family Medicine Physician in Shawnee, OK · enumerated 2013 · authorized official Randy Kerr, Vp of Operations.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1780011874

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Registry record

Entity type Organization (Type 2)
Legal business name Crossroads Medical Management LLC
Practice address 2508 N Harrison St, Shawnee, OK, 74804
Phone (405) 585-2030
Fax (405) 585-0318
Enumeration date Oct 3, 2013
Last updated in NPPES Oct 29, 2025

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 19091 Primary

Authorized official

Name Randy Kerr
Title Vp of Operations
Phone (405) 873-8268

Other identifiers

Identifier Type State Issuer
100131940B Medicaid OK -

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.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Crossroads Medical Management LLC?
Crossroads Medical Management LLC is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-10-29.