Main Street Medical Center, LLC
NPI 1225389919ActiveOrganization· Nurse Practitioner, Family· Red River, NM
Nurse Practitioner, Family in Red River, New Mexico, registered in NPPES in September 2012. The authorized official on file is Jessica L. Cross, FNP-BC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1225389919 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 21, 2012 |
| Last updated in NPPES | Jul 15, 2025 |
| Certified by provider | Jul 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | CNP-01822 | NM |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NM) |
|---|
Other family nurse practitioners in Red River
- 1326344854
- 1588428395