CLEVELAND HEAD & NECK CLINIC (NPI# 1255469235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255469235 |
| Entity Type | Organization |
| Organization Name | CLEVELAND HEAD & NECK CLINIC |
| Practice Address |
2414 Chambliss Ave Nw Cleveland TN 37311-3879 |
| Practice Telephone | 4234726581 |
| Practice Fax Number | 4234722425 |
| Mailing Telephone | 4234726581 |
| Mailing Fax Number | 4234722425 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JACK BYRD (PRESIDENT) |
| Authorized Official Telephone | 4234726581 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3386305 | 05 | |
| TN | BCBS | 0024126 | 01 |
| Street Address |
2414 CHAMBLISS AVE NW |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37311-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235230707 | Kenneth Hugh Mccarley | Otolaryngology | 2414 Chambliss Ave Nw, Cleveland, TN 37311-3879 | 2006-09-26 |
| 1275020711 | Nicole Marie Bahamondes | Audiologist | 2414 Chambliss Ave Nw, Cleveland, TN 37311-3879 | 2018-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114433570 | Kirstee Williams | Counselor | 1120 North Ocoee Street, Lee University, Cleveland, TN 37311 | 2017-12-21 |
| 1285070458 | Scott Daniel Pugh | Counselor | 183 1st St Ne, Cleveland, TN 37311 | 2013-05-15 |
| 1407299191 | Bess E Howard | Nurse Practitioner | 2449 Spring Creek Blvd, Ne, Cleveland, TN 37311 | 2013-04-11 |
| 1588913925 | Thomas C Reese | Hearing Instrument Specialist | 60 25th Street Ne, Suite 5, Cleveland, TN 37311 | 2012-08-30 |
| 1932484607 | Southeast Tn Human Resource Agency | Non-emergency Medical Transport (VAN) | 165 Edwards Street Se, Cleveland, TN 37311 | 2011-10-13 |
| 1588956106 | Lee M Radford | Orthopaedic Surgery | 2350 N Ocoee Street, Cleveland, TN 37311 | 2011-05-16 |
| 1124251913 | Mcfarland Group Inc. | Durable Medical Equipment & Medical Supplies | 1300 25th St Nw # 104, Cleveland, TN 37311 | 2009-08-27 |
| 1952554834 | Bradley Cleveland Services Inc | Counselor | 2611 Bower Lane, Cleveland, TN 37311 | 2008-10-23 |
| 1851543151 | Bradley Cleveland Services, Inc | Counselor | 2601 Bower Lane Se, Cleveland, TN 37311 | 2008-10-17 |
| 1306098082 | Kidney Center of Cleveland, LLC | Clinic/Center | 2253 Chambliss Avenue, Cleveland, TN 37311 | 2008-10-14 |
| Find all providers in zip 37311 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235230707 | Kenneth Hugh Mccarley | Otolaryngology | 2414 Chambliss Ave Nw, Cleveland, TN 37311-3879 | 2006-09-26 |
| 1144330606 | Jack P. Byrd | Otolaryngology | 2414 Chambliss Ave N.w., Cleveland, TN 37311 | 2006-08-30 |
| 1871601286 | Timothy Allen Viser | Otolaryngology | 2414 Chambliss Avenue, Cleveland, TN 37320-5030 | 2006-08-26 |
| 1245338128 | Diana Chuong Ponsky | Otolaryngology | 11100 Euclid Ave, Dept of Otolaryngology, Cleveland, OH 44106-1716 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689654014 | Larry Creston Young | Otolaryngology | 345 23rd Ave North, Suite 412, Nashville, TN 37203 | 2006-01-20 |
| 1427030782 | Frank G Rao | Otolaryngology | 1383 S College St, Winchester, TN 37398-2414 | 2005-11-14 |
| 1801243118 | Joseph Derbyshire | Otolaryngology | 401 S Gallaher View Rd, Apt 10, Knoxville, TN 37919-5308 | 2016-05-17 |
| 1407190853 | David A Gilpin Md Plc | Otolaryngology | 397 Wallace Rd, Suite 101, Nashville, TN 37211-4854 | 2012-11-23 |
| 1750570974 | Head & Neck Specialties, PC | Otolaryngology | 1755 Gunbarrel Rd, Suite 301, Chattanooga, TN 37421-7137 | 2007-10-24 |
| 1952365355 | Thomas Werner Holzen | Otolaryngology | 393 Wallace Rd, Suite 202, Nashville, TN 37211-4880 | 2006-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.