Individual provider Active NPI

Nohemie Brevil, M.D., FAAP

  • Pediatrics Physician
  • Cleveland, MS
National Provider Identifier
1073886446
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23162 Issued in MS
Practice address
818 E Sunflower Rd
Cleveland, MS 38732-2824
Phone
(662) 579-3449
Fax
(662) 579-3459
NPI assigned
Feb 16, 2012
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125057385 IL
Pediatrics Physician 208000000X 23162 MS Primary

Addresses

Primary practice location

818 E Sunflower Rd
Cleveland, MS 38732-2824

Mailing address

PO Box 60
Cleveland, MS 38732-0060
Phone (662) 579-3449

Other identifiers 1

IdentifierTypeStateIssuer
09226861MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802002490 MS Practitioner - Pediatric Medicine 5890156145 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125057385ILMDPediatrics Physician
23162MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Children's Clinic, PLLC Pediatrics CurrentSince Jul 24, 2022 Accepting new patients
Cleveland Children's Clinic, PLLC Pediatrics CurrentSince Jul 19, 2023 Accepting new patients

Locations

818 E Sunflower Rd
Cleveland, MS 38732
Phone (662) 579-3449

1431 S Colorado St
Greenville, MS 38703
Phone (662) 579-3449

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13708/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nohemie.brevil.1@13708.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1073886446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387320060",
            "telephone_number": "662-579-3449",
            "fax_number": "662-579-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 E SUNFLOWER RD",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322824",
            "telephone_number": "662-579-3449",
            "fax_number": "662-579-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREVIL",
        "first_name": "NOHEMIE",
        "name_prefix": "Dr.",
        "credential": "M.D., FAAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125057385",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "23162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09226861",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.