CLEVELAND MEDICAL CLINIC INC (NPI# 1457350951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457350951 |
| Entity Type | Organization |
| Organization Name | CLEVELAND MEDICAL CLINIC INC |
| Practice Address |
2305 Chambliss Ave Nw Cleveland TN 37311-3847 |
| Mailing Address |
4000 Meridian Blvd Franklin TN 37067-6325 |
| Practice Telephone | 4237281650 |
| Practice Fax Number | 4237281655 |
| Mailing Telephone | 8882877705 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2011-09-01 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207Q00000X | Family Medicine | ========= | TN | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3710154 | 05 | |
| TN | BCBS | 3035497 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720149222 | Cleveland Medical Clinic Inc | Pain Medicine | 2305 Chambliss Ave, Cleveland, TN 37320 | 2006-12-12 |
| 1457522633 | Cleveland Medical Clinic Inc | Psychiatry & Neurology | 2700 Westside Dr Nw, Suite 306, Cleveland, TN 37312-3699 | 2008-03-17 |
| Street Address |
2305 CHAMBLISS AVE NW |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37311-3847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154329845 | Howard Kenton Hamilton | Radiology | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2005-07-07 |
| 1710592035 | Jessica Marie Rose | Registered Nurse | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2020-09-14 |
| 1518580893 | Cleveland Tennessee Hospital Company LLC | Medicare Defined Swing Bed Unit | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2020-05-21 |
| 1093345134 | Megan Randolph Justice | Specialist/Technologist, Other | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2020-01-16 |
| 1922565282 | Nicholas Alexander Taylor | Physician Assistant | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2019-02-22 |
| 1720580582 | Zachary Ryan Brown | Physician Assistant | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2018-03-07 |
| 1386193803 | Barratt Lee Schichtel | Nurse Practitioner | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2016-09-26 |
| 1740630243 | Matthew Shachner | Anesthesiology | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2016-06-15 |
| 1740649706 | Jennifer Hinds | Physician Assistant | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2016-02-18 |
| 1760866735 | Ahmadur Rahman Siddiqui | Internal Medicine | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2015-07-19 |
| Find all providers in the same location | ||||
| 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 | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366417396 | James M Osborn | Orthopaedic Surgery | 102 Dunhill Pl Nw, Suite A, Cleveland, TN 37311-3885 | 2006-02-22 |
| 1528434412 | Assem Sultan | Orthopaedic Surgery | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2015-08-14 |
| 1861886772 | Haariss Ilyas | Orthopaedic Surgery | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2015-03-28 |
| 1366861882 | Young Lu | Orthopaedic Surgery | 9500 Euclid Ave # S40, Cleveland, OH 44195-0001 | 2014-04-11 |
| 1710305511 | Joseph Paul Maslak | Orthopaedic Surgery | 9500 Euclid Ave, Cleveland, OH 44195 | 2014-03-31 |
| 1275776171 | Jonathan Edwards Belding | Orthopaedic Surgery | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2009-04-08 |
| 1336395516 | Jerold P. Gurley M.d., P.C., Inc. | Orthopaedic Surgery | 7215 Old Oak Blvd, Suite A421, Cleveland, OH 44130-3340 | 2008-08-07 |
| 1124148358 | Garrick W. Cason | Orthopaedic Surgery | 102 Dunhill Pl Nw, Ste A, Cleveland, TN 37311-3885 | 2007-03-30 |
| 1811076482 | Clyde L Nash | Orthopaedic Surgery | 2500 Metrohealth Dr, Department of Orthopaedics, Cleveland, OH 44109-1900 | 2006-11-03 |
| 1902993512 | Jerold P Gurley | Orthopaedic Surgery | 7215 Old Oak Blvd, Suite A421, Cleveland, OH 44130-3340 | 2006-10-06 |
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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.