Minnie Maxine Cleveland, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

R41003 Issued in SC

Practice address

9 Richland Medical Park - Suite 305
Palmetto Health Richland - Diabetes Education
Columbia, SC 29203-6863

Phone

(803) 434-7027

Fax

(803) 434-1239

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104950088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RICHLAND MEDICAL PARK DR",
            "address_2": "PALMETTO HEALTH RICHLAND - DIABETES EDUCATION",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-7027",
            "fax_number": "803-434-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK - SUITE 305",
            "address_2": "PALMETTO HEALTH RICHLAND - DIABETES EDUCATION",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-7027",
            "fax_number": "803-434-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "MINNIE",
        "middle_name": "MAXINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "SC",
            "license": "R41003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DPE012",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clemson Modern Dentistry, PC
• Clemson Sports Medicine and Rehabilitation
• Clemson Sports Medicine and Rehabilitation, Inc.
• John Clendenin
• Clergy for Educational Options
• Jeffrey Cabot Clevenger, MD
• Brian P Cline, MD
• Casey Cline, MS, LPC, LCAT, ATR-B
• Candace Clinton, MD
• Christina Clinton

• All providers in Columbia, SC
• Diabetes Educator Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.