Active NPI
Teresa Cleaves, CSA
- Surgical Physician Assistant
- Jonesboro, GA
National Provider Identifier
1013154483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 03012108
- Practice address
- 804 River Mist Dr
Jonesboro, GA 30238-5748 - Phone
- (770) 985-4257
- Fax
- (770) 985-4258
- NPI assigned
- Jan 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 03012108 | GA | Primary |
Addresses
Primary practice location
804 River Mist Dr
Jonesboro, GA 30238-5748
Mailing address
804 River Mist Dr
Jonesboro, GA 30238-5748
Phone (770) 985-4257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03012108 | GA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1013154483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 RIVER MIST DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302385748",
"telephone_number": "770-985-4257",
"fax_number": "770-985-4258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 RIVER MIST DR",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302385748",
"telephone_number": "770-985-4257",
"fax_number": "770-985-4258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEAVES",
"first_name": "TERESA",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "03012108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.