{
  "npi": "1174040034",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MD",
    "authorized_official_first_name": "RUPERT",
    "authorized_official_last_name": "MCCORMAC",
    "authorized_official_telephone_number": "8008056989",
    "authorized_official_title_or_position": "Chief Executive Officer",
    "certification_date": "2024-11-08",
    "enumeration_date": "2017-08-23",
    "last_updated": "2024-11-08",
    "organization_name": "CROSSROADS TREATMENT CENTER OF NORTHERN KENTUCKY, PSC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1974 WALTON NICHOLSON PIKE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "INDEPENDENCE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "859-359-0739",
      "postal_code": "410517906",
      "state": "KY",
      "telephone_number": "859-359-5404"
    },
    {
      "address_1": "PO BOX 749057",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ATLANTA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "864-558-8511",
      "postal_code": "303749057",
      "state": "GA",
      "telephone_number": "800-805-6989"
    }
  ],
  "taxonomies": [
    {
      "code": "251S00000X",
      "desc": "Community/Behavioral Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0801X",
      "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM1300X",
      "desc": "Clinic/Center, Multi-Specialty",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM2800X",
      "desc": "Clinic/Center, Methadone Clinic",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QP2300X",
      "desc": "Clinic/Center, Primary Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QR0405X",
      "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": {
    "total_beneficiaries": "17",
    "total_services": "623",
    "total_medicare_allowed_amt": "74646.77",
    "top_hcpcs_services": [
      {
        "code": "G2067",
        "description": "Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm",
        "services": "240",
        "beneficiaries": "16"
      },
      {
        "code": "G2078",
        "description": "Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure",
        "services": "368",
        "beneficiaries": "14"
      }
    ]
  },
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "D5",
        "medicare_type": "Opioid Treatment Program"
      }
    ]
  }
}