Active NPI
William Cleland, M.D.
- Reproductive Endocrinology Physician
- Jackson, MS
National Provider Identifier
1013948918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- 207VEO102X
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 984-5373
- Fax
- (601) 984-5476
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | 207VEO102X | MS | Primary |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5373
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160059087 | Other | MS | RR MEDICARE NUMBER |
| 00126467 | Medicaid | MN | |
| 512G700003 | Other | MS | UP MEDICARE GROUP PROV# |
| 08103071 | Other | MS | UP MEDICAID GROUP PROV# |
| 512I160007 | Other | MS | MEDICARE PTAN |
| 09014712 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207VEO102X | MS | MD | Reproductive Endocrinology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1013948918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5373",
"fax_number": "601-984-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5373",
"fax_number": "601-984-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLELAND",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MS",
"license": "207VEO102X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE NUMBER",
"identifier": "160059087",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00126467",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UP MEDICARE GROUP PROV#",
"identifier": "512G700003",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UP MEDICAID GROUP PROV#",
"identifier": "08103071",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "512I160007",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09014712",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.