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NPI Code Detail

MEDICARE: CLEVELAND MEDICAL CLINIC INC

MEDICARE: CLEVELAND MEDICAL CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2363LF0000XFamily Nurse Practitioner
3363A00000XPhysician Assistant
42084N0400XNeurology Physician
5207RN0300XNephrology Physician
6207Q00000XFamily Medicine PhysicianTN
7207XS0117XOrthopaedic Surgery of the Spine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23035497OTHERTNBCBS

General Provider Information

NPI Number : 1457350951
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND MEDICAL CLINIC INC
Provider Business Mailing Address
First Line : 4000 MERIDIAN BLVD
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-6325
Country : US
Telephone Number : 888-287-7705
Fax Number :
Provider Business Practice Location Address
First Line : 2305 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3847
Country : US
Telephone Number : 423-728-1650
Fax Number : 423-728-1655
Authorized Official
Title or Position : DIRECTOR
Name : DEBBIE BREWER
Credential :
Telephone Number : 877-892-9813
Provider Enumeration Date : 07/18/2005
Last Update Date : 07/21/2022

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Directions to “CLEVELAND MEDICAL CLINIC INC ” Practice Location

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